Scholarlink

Background <p>Peroral Endoscopic Myotomy (POEM) has become the first-line minimally invasive treatment for achalasia. Its short-term and mid-term (1–5&#xa0;years) efficacy has been consistently demonstrated, but long-term follow-up data (≥ 5&#xa0;years) remain limited. This systematic review and meta-analysis aims to comprehensively evaluate the long-term (median follow-up ≥ 5&#xa0;years) clinical efficacy and safety of POEM.</p> Methods <p>Using medical literature databases, we retrieved randomized controlled trials (RCTs) and non-randomized comparative studies from the inception of the databases through September 2025. Data were extracted using the Cochrane Risk of Bias 2.0 tool and the Newcastle–Ottawa Scale to assess risk of bias for RCTs and cohort studies, respectively. Meta-analyses were conducted using either fixed-effect or random-effects models.</p> Results <p>A total of 16 studies involving 2421 patients (50.4% male) were included, with a median follow-up duration of 72&#xa0;months (range, 60–144&#xa0;months). The pooled clinical success rate was 87.1% (95% CI 82.4–91.8%; I<sup>2</sup> = 84.2%). The pooled incidence of endoscopically detectable reflux esophagitis was 24.2% (95% CI 11.6–36.8%; I<sup>2</sup> = 85.4%), whereas symptomatic reflux was inconsistently reported, with a pooled incidence of 27.2% (95% CI 19.2–35.3%; I<sup>2</sup> = 83.6%). Long-term follow-up reported 2 cases of Barrett's esophagus and isolated cases of esophageal cancer.</p> Conclusion <p>POEM has demonstrated consistent long-term efficacy and safety. Postoperative symptomatic reflux is the most common long-term complication, while the risks of Barrett's esophagus and peptic stricture remain low. POEM represents a reliable first-line treatment option; however, further multicenter prospective studies are needed to validate its long-term efficacy and safety.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Long-term outcomes of peroral endoscopic myotomy for achalasia: a systematic review and meta-analysis with median follow-up ≥ 5 years

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月10日

查看全文
  • Yuxin Chen,
  • Yifei Chen,
  • Bin Lv

摘要

Background

Peroral Endoscopic Myotomy (POEM) has become the first-line minimally invasive treatment for achalasia. Its short-term and mid-term (1–5 years) efficacy has been consistently demonstrated, but long-term follow-up data (≥ 5 years) remain limited. This systematic review and meta-analysis aims to comprehensively evaluate the long-term (median follow-up ≥ 5 years) clinical efficacy and safety of POEM.

Methods

Using medical literature databases, we retrieved randomized controlled trials (RCTs) and non-randomized comparative studies from the inception of the databases through September 2025. Data were extracted using the Cochrane Risk of Bias 2.0 tool and the Newcastle–Ottawa Scale to assess risk of bias for RCTs and cohort studies, respectively. Meta-analyses were conducted using either fixed-effect or random-effects models.

Results

A total of 16 studies involving 2421 patients (50.4% male) were included, with a median follow-up duration of 72 months (range, 60–144 months). The pooled clinical success rate was 87.1% (95% CI 82.4–91.8%; I2 = 84.2%). The pooled incidence of endoscopically detectable reflux esophagitis was 24.2% (95% CI 11.6–36.8%; I2 = 85.4%), whereas symptomatic reflux was inconsistently reported, with a pooled incidence of 27.2% (95% CI 19.2–35.3%; I2 = 83.6%). Long-term follow-up reported 2 cases of Barrett's esophagus and isolated cases of esophageal cancer.

Conclusion

POEM has demonstrated consistent long-term efficacy and safety. Postoperative symptomatic reflux is the most common long-term complication, while the risks of Barrett's esophagus and peptic stricture remain low. POEM represents a reliable first-line treatment option; however, further multicenter prospective studies are needed to validate its long-term efficacy and safety.