Complications of submucosal endoscopy

Jean-Michel Gonzalez, Alban Benezech and Marc Barthet
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Jean-Michel Gonzalez: Hôpital Nord [CHU - APHM]
Alban Benezech: Service de Gastroentérologie - APHM - Assistance Publique - Hôpitaux de Marseille - Hôpital Nord [CHU - APHM]
Marc Barthet: LBA UMR T24 - Laboratoire de Biomécanique Appliquée - AMU - Aix Marseille Université - Université Gustave Eiffel

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Abstract: Submucosal endoscopy essentially regroups peroral endoscopic esophageal ă myotomy (POEM) and, more recently, pyloromyotomy and tunnel tumor ă resections. The complication rate of POEM is between 5% and 10%. ă Complications include gas-related complications, mucosal tears, and ă bleeding, and are usually managed conservatively or with non-surgical ă procedures. Only one case of death has been reported. The most commonly ă identified risk factors for complicated procedures in POEM are short ă experience with the technique and sigmoid-type esophagus. The rate of ă gastro-esophageal reflux (GERD) is between 10% and 30% depending on ă the definitions, with a good clinical response to proton pump ă inhibitors. For the techniques other than POEM, the number of cases ă reported is too small to allow identification of the complications, ă which, in addition, probably vary depending on the organ involved. ă The management of gas-related complications is conservative and ă sometimes requiring percutaneous exsufflation (capnoperitoneum) or ă drainage. The endoscopic management of mucosal tears essentially ă involves clip placement and, in case of bleeding, the usual hemostasis ă techniques including stent placement. Importantly, following a rigorous ă and appropriate learning program is essential to minimize the risk of ă complications, particularly for specialists with a short experience in ă the technique. (C) 2016 Elsevier Ltd. All rights reserved.

Keywords: quality (search for similar items in EconPapers)
Date: 2016-10
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Published in Best Practice and Research: Clinical Gastroenterology, 2016, 30 (5), pp.783-791. ⟨10.1016/j.bpg.2016.10.015⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-01482387

DOI: 10.1016/j.bpg.2016.10.015

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