经口内镜下肌层切开术治疗贲门失弛缓症的临床应用进展

Peroral endoscopic myotomy for treatment of achalasia

贲门失弛缓症(achalasia,AC)是一种食管动力学功能障碍性疾病,以食管体部正常蠕动消失、吞咽时食管下段括约肌(lower esophageal sphincter,LES)松弛不良为特征.经口内镜下肌切开术(peroral endoscopic myotomy,POEM)是治疗AC的一种新兴方法,其主要是通过经口的内镜,在食管黏膜层与固有肌层之间建立一条隧道,通过该隧道对LES进行切开,以缓解患者症状.POEM因近期疗效确切及创伤小等特点,目前受到广泛关注.本文就POEM手术最新的进展情况做一综述.

Achalasia is a motility disorder of the esophagus, characterized by aperistalsis of the esophageal body and incomplete relaxation of the lower esophageal sphincter （LES）. Peroral endoscopic myotomy （POEM） is an emerging novel endoscopic procedure for the treatment of achalasia by incision of LES via a submucosal tunnel. On the basis of initial data suggesting an acceptable safety profile and excellent short-term symptom resolu＇tion, there is growing enthusiasm in favor of POEM. In this review we outline the technical aspects of POEM, summarize the available data on safety and outcomes, and suggest future directions for further advancement of this minimally invasive approach for the treatment of achalasia.