Periprocedural complications of POEM
Authors:
L. Nosáková 1; Ďuriček M. 1; P. Bánovčin Jr. 1; Trabalkova Z. 2; Hyrdel R. 1; Demeter M. 1
Authors‘ workplace:
Interná klinika gastroenterologická JLF UK a UN Martin
1; Radiologická klinika JLF UK a UN Martin
2
Published in:
Gastroent Hepatol 2019; 73(3): 208-214
Category:
Digestive Endoscopy: Original Article
doi:
https://doi.org/10.14735/amgh2019208
Overview
Introduction: Achalasia is a rare primary esophageal motility disorder characterized by aperistalsis and the concomitant absence of relaxation of the lower esophageal sphincter. The introduction of a new technique, called peroral endoscopic myotomy (POEM), significantly advanced treatment of this condition. This study focused on the periprocedural complications of POEM.
Methods: The incidence of periprocedural complications in patients with esophageal achalasia who had undergone POEM was retrospectively analyzed.
Results: POEM was successfully performed in 132 of 136 patients. POEM was anterior in most patients (n = 109) and posterior in 23 patients. Fifty patients (38%) experienced complications during surgery. The most frequent complication was thermal damage of the mucosa (27.3%). The second most common complication was capnoperitoneum (14%). Severe capnoperitoneum occurred in five patients (3.8%). Subcutaneous emphysema was observed in six patients (4.5%). Seven patients (6%) experienced periprocedural perforation. Among all patients who developed complications, two required subsequent surgical treatment. There was no performance-related death in our patient population.
Conclusion and discussion: POEM is a worldwide accepted therapy for achalasia. It is generally considered to be a safe method with a low incidence of serious complications. Data concerning the incidence of perioperative complications vary, particularly with regard to what is considered to be a complication and what is a normal part of surgery. However, severe life-threatening complications are rare.
Keywords:
achalasia – POEM – periprocedural complications
Sources
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