Comprehensive Analysis of Adverse Events Associated with Gastric Peroral Endoscopic Myotomy: An International Multicenter Study
| Autor: | Yervant Ichkhanian, Mohamad I. Itani, Joseph Triggs, N. Browers, Olaya Brewer, Jérémie Jacques, Shivangi Dorwat, Eduardo Albéniz, Amol Bapaye, Mouen A. Khashab, Andrey Iskrenov Kotzev, Amrita Sethi, Maximilien Barret, Petros C. Benias, Peter V. Draganov, A. Aziz Aadam, Michael B. Ujiki, Kia Vosoughi, M. Aghaie Meybodi, Ryan J. Law, Anish Patel, Mathieu Pioche, Zachary M. Callahan, Dalton Marques Chaves, Fermín Estremera |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Myotomy Abdominal pain medicine.medical_specialty Gastroparesis Internationality Time Factors medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Pyloromyotomy Physicians Internal medicine medicine Humans Adverse effect Retrospective Studies business.industry Incidence (epidemiology) Retrospective cohort study Middle Aged medicine.disease Treatment Outcome Case-Control Studies 030220 oncology & carcinogenesis Etiology Female 030211 gastroenterology & hepatology Surgery medicine.symptom business Abdominal surgery |
| Zdroj: | Surgical Endoscopy. 35:1755-1764 |
| ISSN: | 1432-2218 0930-2794 |
| DOI: | 10.1007/s00464-020-07570-z |
| Popis: | Gastric peroral endoscopic myotomy (G-POEM) has emerged as an effective management approach for patients with refractory gastroparesis. This study aims to comprehensively study the safety of G-POEM and describe the predictive factors of adverse events (AEs) occurrence.This study is a retrospective study involving 13 tertiary care centers (7 USA, 1 South America, 4 Europe, and 1 Asia). Patients who underwent G-POEM for refractory gastroparesis were included. Cases were identified by the occurrence of AEs. For each case, two controls were randomly selected and matched for age (± 10 years), gender, and etiology of gastroparesis.A total of 216 patients underwent G-POEM for gastroparesis. Overall, 31 (14%) AEs were encountered [mild 24 (77%), moderate 5 (16%), and severe 2 (6%)] during the duration of the study. The most common AE was abdominal pain (n = 16), followed by mucosotomy (n = 5) and capnoperitoneum (n = 4), and AEs were most commonly identified within the first 48-h post-procedure 18 (58%). The risk of adverse event occurrence was significantly higher for endoscopists with experience of 20 G-POEM procedures (OR 3.03 [1.03-8.94], p 0.05).G-POEM seems to be a safe intervention for refractory gastroparesis. AEs are most commonly mild and managed conservatively. Longitudinal mucosal incision, use of hook knife, use of clips for mucosal closure and endoscopist's experience with 20 G-POEM procedures is significantly associated with decreased incidence of AEs. |
| Databáze: | OpenAIRE |
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