Gastroenterologie
a hepatologie

Periprocedural complications of POEM

Lenka Nosáková¹, Martin Ďuriček ^{Orcid.org  2}, Peter Bánovčin ^{Orcid.org  3}, Zuzana Trabalková⁴, Rudolf Hyrdel ^{Orcid.org  2}, Michal Demeter ^{Orcid.org  5}

+ Affiliation
¹ Interná klinika gastroenterologická JLF UK a UN Martin
² Interná klinika gastroenterologická JLF UK a UN Martin, Slovenská republika
³ Klinika detí a dorastu JLF UK a UN Martin
⁴ Radiologická klinika JLF UK a UN Martin
⁵ Interná klinika gastroenterologická, Jesseniova lekárska fakulta UK a Univerzitná nemocnica Martin

Summary

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

POEM, achalasia, periprocedural complications

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