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©The Author(s) 2024.
World J Gastrointest Endosc. Oct 16, 2024; 16(10): 566-580
Published online Oct 16, 2024. doi: 10.4253/wjge.v16.i10.566
Published online Oct 16, 2024. doi: 10.4253/wjge.v16.i10.566
Table 1 Baseline characteristics of the studies on peroral endoscopic myotomy for achalasia in pediatric patients
| Ref. | Country | Study type | Study interval | Patients (n) | Gender (M:F) | Age (yr) | Duration of symptoms (month) | Myotomy length (cm) | Operation time (min) | Hospital stay (day) | Follow-up (month) | Method of GERD diagnosis |
| Li et al[19], 2015 | China | Prospective | October 2011 to March 2014 | 9 | 4:5 | 14.1 (10-17) | 26.4 (6-60) | 8.3 | 56.7 | - | 16.3 (3-30) | Esophageal manometry, barium esophagram and EGD |
| Chen et al[20], 2015 | China | Prospective | August 2010 to July 2012 | 27 | 11:16 | 13.8 (6-17) | 20.4 (6-36) | 9.6 (7-11) | 39.4 (21-90) | 3.2 (1-7) | 24.6 (15-38) | EGD |
| Caldaro et al[21], 2015 | Italy | Retrospective | 2009 to 2014 | 9 | 3:6 | 12.2 ± 3.8 | - | 11 ± 2 | 62 ± 12.7 | 4.1 (2-7) | 12.7 (5-28) | pH-monitoring and EGD |
| Tang et al[22], 2015 | China | Retrospective | July 2012 to August 2014 | 5 | 3:2 | 15 | 12 (3-15) | 8 (6-11) | 50 (40-90) | 7 (5-13) | 18 (12-23) | EGD, mano-metry |
| Tan et al[23], 2016 | China | Retrospective | January 2007 to June 2015 | 12 | 6:6 | 13.7 ± 2.6 | 23.6 ± 16.8 | - | - | - | 36 | EGD, esophageal manometry |
| Stavropoulos et al[24], 2017 | United States | Retrospective1 | 2013 to 2016 | 10 | 7:3 | 14.7 (10-17) | 21 (3-84) | 11.4 ± 5.98 | 55 (33-111) | 1.2 (1-2) | 15 (1-30) | - |
| Zangen et al[25], 2017 | Israel | Retrospective1 | - | 5 | 2:3 | 15.4 (10- 18) | - | 11.2 (10-14) | 62 (43-73) | - | 6 | HRM |
| Kethman et al[26], 2018 | United States | Prospective | 2014 to 2016 | 10 | 8:2 | 13.4 ± 3.3 | - | 7 (4-9) | 142 (60-259) | - | - | - |
| Miao et al[27], 2018 | China | Prospective | October 2014 to October 2016 | 21 | 9:12 | 5.5 (0.9-18) | 18 (3.6-30) | 9 (6-11) | 40 (30-55) | 9 (7-12) | 13.2 (3-24) | 99mTc DTPA scintigraphic examinations, gastroscopy and esophageal manometry |
| Korrapati et al[28], 2018 | India | Retrospective1 | - | 15 | 10:5 | 15 (3-18) | 21.9 (6-54) | 8 (6-11) | 85.3 ± 31 | 4.4 ± 2.5 | 19.8 (1.5-51) | EGD |
| Nishimoto et al[29], 2018 | Japan | Retrospective1 | May 2015 to November 2017 | 13 | - | 15 (10-18) | - | - | - | - | 18.3 (0-30) | - |
| Mangiola et al[30], 2018 | Italy | Retrospective1 | January 2012 to June 2017 | 26 | 12:14 | 10.9 (2-17) | 18.2 ± 14.9 | 10 ± 2.6 | 56.2 ± 12.6 | 3.7 ± 1.7 | 30.2 ± 15.4 | Manometry, 24 h pH-monitoring, and EGD |
| Yamashita et al[31], 2018 | Japan | Retrospective1 | September 2011 to June 2017 | 7 | - | 15.0 (9-18) | 30.7 (1-84) | 14 (7-24) | - | - | 39.6 (18-54) | - |
| Choné et al[32], 2019 | France | Retrospective | January 2012 to August 2018 | 117 | 69:48 | 14.2 (3.7) | 21.3 (21.2) | 8.3 (3-21) | 72.5 (16-240) | 3.9 (1-14) | 18 (3.3-53.7) | - |
| Nabi et al[33], 2019 | India | Retrospective | September 2013 to Jan 2018 | 44 | 22:21 | 14.58 ± 3.41 | 24 (2-96) | 10.09 (5-15) | 65.46 (18-240) | 3 (2-4) | 18 (1-53.1) | Symptoms, EGD and 24-h pH-impedance |
| Liu et al[34], 2019 | China | Retrospective | August 2010 to August 2017 | 130 | 82:48 | - | 12 (0-13) | 7.2 ± 1.4 | 30 (15-255) | 3 (1-21) | 40 (4-88) | Barium swallow, EGD and HRM |
| Saez et al[35], 2020 | Chile | Retrospective | March 2017 to November 2019 | 5 | 4:1 | 11 (5-15) | - | 9.8 (9-11) | 70 (50-120) | 2 (1-3) | 20.5 (4 -37) | EGD and HRM |
| Wood et al[36], 2020 | United States | Prospective | 2014 to 2019. | 21 | 14:7 | 13 (2-17) | - | 7 ± 1.1 | 92 ± 52 | 1 ± 0.5 | 12 | - |
| Peng et al[37], 2022 | China | Retrospective | October 2011 to November 2016 | 24 | 14:10 | 14.42 ± 2.65 | 14.5 (3-84) | 9 (5-10) | 58.67 ± 19.10 | 6.42 ± 2.15 | 85.75 ± 25.91 | Gerd Q score and EGD |
| Petrosyan et al[38], 2022 | United States | Retrospective | July 2015 to September 2021 | 37 | 23:14 | 11.6 ± 4.5 | - | 6.5 ± 0.93 | 138.1 ± 62.2 | 2.4 ± 0.9 | 22.6 ± 20 | - |
Table 2 Clinical outcomes of the studies on peroral endoscopic myotomy for achalasia in pediatric patients, n (%)
| Ref. | Technical success | Clinical success | GERD | Adverse events |
| Li et al[19], 2015 | 9/9 (100) | 9/9 (100) | 1/9 (11.1) | 2/9 (11.1) |
| Chen et al[20], 2015 | 26/27 (96.3) | 26/26 (100) | 5/26 (19.2) | 9/26 (34.6) (Cumulative adverse events on CT scan: 53) |
| Caldaro et al[21], 2015 | 9/9 (100) | 9/9 (100) | 1/9 (11.1) | 1/9 (11.1) |
| Tang et al[22], 2015 | 5/5 (100) | 4/4 (100) | 0 (0) | 0 (0) |
| Tan et al[23], 2016 | 12/12 (100) | 12/12 (100) | 2/12 (16.7) | 3/12 (8.3) |
| Stavropoulos et al[24], 2017 | 10/10 (100) | 10/10 (100) | 2/5 (40) | 4/10 (40) |
| Zangen et al[25], 2017 | 5/5 (100) | 5/5 (100) | 0 (0) | 0 (0) |
| Kethman et al[26], 2018 | 10/10 (100) | 8/10 (80) | 0 (0) | 3/10 (30) |
| Miao et al[27], 2018 | 21/21 (100) | 21/21 (100) | 6/21 (28.6) | 12/21 (57.1) |
| Korrapati et al[28], 2018 | 15/15 (100) | 15/15 (100) | 0 (0) | 2/15 (13.3) |
| Nishimoto et al[29], 2018 | 13/13 (100) | 12/13 (92.3) | - | 2/13 (15.4) |
| Mangiola et al[30], 2018 | 25/26 (96.2) | 26/26 (100) | 4/17 (23.5) | 6/26 (23.1) |
| Yamashita et al[31], 2018 | 7/7 (100) | 7/7 (100) | - | 0 (0) |
| Choné et al[32], 2019 | 116/117 (99.1) | 106/117 (90.6) | 17/117 (21.4) | 7/117 (8.5) |
| Nabi et al[33], 2019 | 43/44 (97.7) | 40/44 (90.9) | 11/20 (55) | 11/43 (25.6) |
| Liu et al[34], 2019 | 129/130 (99.2) | 108/113 (95.6) | 30/111 (27.0) | 5/130 (3.8) |
| Saez et al[35], 2020 | 5/5 (100) | 5/5 (100) | 2/5 (40) | 0 (0) |
| Wood et al[36], 2020 | 21/21 (100) | 21/21 (100) | - | 6/21 (28.6) |
| Peng et al[37], 2022 | 24/24 (100) | 23/24 (95.8) | 5/21 (23.8) | 0 (0) |
| Petrosyan et al[38], 2022 | 37/37 (100) | 37/37 (100) | 3/37 (8.1) | 9/37 (24.3) |
Table 3 Baseline characteristics of the studies on peroral endoscopic myotomy for achalasia in geriatric patients
| Ref. | Country | Study type | Study interval | Patients (n) | Gender (M:F) | Age (yr) | Duration of symptoms (month) | Myotomy length (cm) | Operation time (min) | Hospital stay (day) | Follow-up (month) | Method of GERD diagnosis |
| Wang et al[39], 2016 | China | Retrospective | January 2010 to December 2015 | 21 | 12:9 | 67.9 ± 4.3 | 13.9 ± 11.7 | - | - | - | 21.8 | EGD, esophageal manometry and barium esophagram |
| Chen et al[13], 2018 | United States | Retrospective | January 2010 to January 2016 | 76 | 40:36 | 84 ± 3.2 | 24.0 (17.8-30.3) | 10.0 ± 4.0 | 103.7 ± 47.9 | 3 | 8.5 (IQR: 2.2-18.2) | - |
| Landi et al[40], 2018 | Italy | Retrospective1 | May 2011 to April 2017 | 88 | 39:49 | 72.2 ± 4.7 | - | 12.3 ± 3 | - | - | 24 | - |
| Liu et al[41], 2019 | China | Retrospective | August 2010 to December 2017 | 139 | 65:74 | 70.22 ± 5.68 | 8 (IQR: 2-20) | 10.57 ± 1.81 | 50 (IQR: 36-76) | 3 (IQR: 2-4) | 41 (IQR: 26-60) | Barium swallow, EGD and HRM |
| Klair et al[42], 2019 | United States | Retrospective1 | December 2014 to October 2018 | 62 | 36:26 | 72.3 ± 5.7 | - | 13.8 | - | 1.9 | - | - |
| Abe et al[43], 2020 | Japan | Retrospective | April 2015 to March 2019 | 28 | 12:16 | ≥ 80 | 5.5 (0.25-59) | 14.5 (4-26) | 60.5 (36-124) | 9.8 (4-51) | - | EGD and HRM |
| Sanaka et al[44], 2020 | United States | Retrospective | April 2014 to May 2019 | 55 | 31:24 | 74 (70-79) | 30 (12-60) | 10 (IQR: 8-10) | 90 (IQR: 7.5-110) | 1 (IQR: 1-2) | 2.4 (IQR: 2.2-2.7) | HRM, timed barium esophagram and 24-h esophageal pH study |
| Angeli Abad et al[45], 2020 | Netherlands | Retrospective1 | September 2008 to June 2019 | 66 | 28:38 | 83 (80-92) | 10.5 (0.2-62.4) | - | - | 7 ± 4.1 | 12 | - |
| Okada et al[46], 2021 | Japan | Retrospective | September 2011 to March 2020 | 100 | 40:60 | 74.2 (65-93) | 10.3 ± 13.6 | 12.5 (3-25) | 138.3 (50-460) | - | 36 | - |
| Nakamura et al[47], 2021 | Japan | Retrospective | August 2014 to May 2021 | 11 | 7:4 | 81 (75-87) | 5 (2-40) | 13 (8-19) | 109 (62-144) | - | 36 | EGD, esophagography and HRM |
| Ujiie et al[48], 2021 | Japan | Retrospective | January 2015 to December 2019 | 18 | 12:6 | 78 (75-86) | 4.4 (0.05-50.2) | 10 (5-16) | 104 (45-165) | - | 2 | IRP, HRM and EGD |
| Zhao et al[49], 2022 | China | Retrospective1 | November 2010 to September 2019 | 146 | - | - | - | 7.09 ± 2.49 | 46.87 ± 19.29 | - | - | GerdQ score |
Table 4 Results of the studies on peroral endoscopic myotomy for achalasia in geriatric patients, n (%)
| Ref. | Technical success | Clinical success | GERD | Adverse events |
| Wang et al[39], 2016 | 21/21 (100) | 20/21 (95.2) | 2/21 (9.5) | 1/21 (4.8) |
| Chen et al[13], 2018 | 71/76 (93.4) | 59/65 (90.8) | 13/76 (16.1) | 11/76 (14.5) |
| Landi et al[40], 2018 | 88/88 (100) | 84/88 (95.4) | - | - |
| Liu et al[41], 2019 | 138/139 (99.3) | 79/85 (92.9) | 20/85 (23.53) | 4/139 (2.88) |
| Klair et al[42], 2019 | 62/62 (100) | 55/62 (88.7) | - | 5/62 (8.1) |
| Abe et al[43], 2020 | 28/28 (100) | 17/17 (100) | 3/23 (13.0) | 8/28 (28.6) |
| Sanaka et al[44], 2020 | 55/55 (100) | 36/38 (94.7) | 6/51(11.8) | 3/55 (5.5) |
| Angeli Abad et al[45], 2020 | 66/66 (100) | 19/20 (95.0) | - | 5/66 (7.6) |
| Okada et al[46], 2021 | 100/100 (100) | 92/92 (100) | - | 11/100 (11) |
| Nakamura et al[47], 2021 | 11/11 (100) | 11/11 (100) | 1/11 (9) | 3/11 (27.3) |
| Ujiie et al[48], 2021 | 18/18 (100) | 18/18 (100) | 1/18 (5.6) | 0 (0) |
| Zhao et al[49], 2022 | 146/146 (100) | (96.33) | (15.60) | - |
- Citation: Pu XX, Huang S, Zhong CY, Wang X, Fu SF, Lv YQ, Zou K, Lü MH, Peng Y, Tang XW. Safety and efficacy of peroral endoscopic myotomy for treating achalasia in pediatric and geriatric patients: A meta-analysis. World J Gastrointest Endosc 2024; 16(10): 566-580
- URL: https://www.wjgnet.com/1948-5190/full/v16/i10/566.htm
- DOI: https://dx.doi.org/10.4253/wjge.v16.i10.566