Peroral endoscopic myotomy (POEM) is a widely accepted, effective endoscopic procedure for the management of achalasia. Although POEM is considered a relatively safe procedure, studies have reported varying rates of adverse events (AEs), ranging from mild to severe. The practice of grading AEs currently involves the use of the Clavien-Dindo classification (ranges from grade I [any deviation from the normal course] to grade V [death]) or the American Society for Gastrointestinal Endoscopy (ASGE) lexicon (ranges from mild [procedure aborted\/not started, medical consult, unplanned hospitalization <3 days] to severe [prolonged intensive care unit admission, permanent disability, death]). The authors of this single-center retrospective study reported POEM-related AEs and evaluated a scoring system to predict AEs. <\/p>\n\n\n\n
The study included 3135 patients (mean age, 41 years; 50% male) who had undergone POEM for achalasia. Adverse events were reported in 258 patients (8.23%). These mainly included pleural effusion (n=199), pneumothorax (n=50), delayed mucosal barrier failure (n=13), delayed bleeding (n=7), and miscellaneous AEs (n=28; inflammation, stroke, coma, etc.). <\/p>\n\n\n\n
Using the Clavien-Dindo classification to grade the patients\u2019 AEs, 175 patients (67.83%) received grade I, 23 (8.91%) grade II, 56 (21.71%) grade III, 4 (1.55%) grade IV, and 0 (0%) grade V. The same AEs were classified as mild, moderate, and severe, according to the ASGE lexicon, in 175 cases (67.83%), 66 (25.58%), and 17 (6.59%), respectively. <\/p>\n\n\n\n
On multivariate analyses, air insufflation (13.39; 95% confidence interval [CI], 8.13-22.23), mucosal injury (1.8; 95% CI, 1.21-2.30), operation time of 60 minutes (2.77; 95% CI, 1.09-2.89), and selective myotomy (7.71; 95% CI, 4.70-12.63) were significantly associated with AEs. These were scored as 18, 3, 5, and 5, respectively, and incorporated into a risk calculator, which demonstrated the mean area under the curve of 0.795 in predicting POEM-related AEs. Higher scores were associated with higher risk of AEs (scores of 15-19, 9.8%; 20-24, 12.15%; 25-29, 20%; 30-34, 33.33%).<\/p>\n","protected":false},"excerpt":{"rendered":"
Peroral endoscopic myotomy (POEM) is a widely accepted, effective endoscopic procedure for the management of achalasia. Although POEM is considered a relatively safe procedure, studies have reported varying rates of adverse events (AEs), ranging from mild to severe. The practice of grading AEs currently involves the use of the Clavien-Dindo classification (ranges from grade I … Read more<\/a><\/p>\n","protected":false},"template":"","categories":[1768,1791],"tags":[2432,2799,2098,2578,237],"class_list":["post-10547","ec-news","type-ec-news","status-publish","hentry","category-asge-journal-scan","category-esophagus","tag-adverse-events","tag-aes","tag-esophagus-2","tag-peroral-endoscopic-myotomy-2","tag-poem"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news\/10547","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/ec-news"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=10547"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=10547"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=10547"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}