Risk factors of gas–related complications in peroral endoscopic myotomy for achalasia

Objective To investigate the risk factors and incidence of gas–related complications in peroral endoscopic myotomy for easophageal achalasia. Methods Clinical data of 216 patients with achalasia treated by peroral endoscopic myotomy from August 2011 to November 2013 were collected. Potential risk factors for gas–related complications were analyzed by univariate and multivariate analysis. Results The incidence of gas–related complications was 10.2%(22/216). Univariate analysis showed risk factors for complications were Sigmoid type esophagus, simple longitudinal incision for tunnel entry, tunnel width ≤3 cm, degree of myotomy, and operation time(P<0.05), while multivariate analysis showed the risk factors were Sigmoid type esophagus, simple longitudinal incision for tunnel entry, and tunnel width ≤3 cm(P<0.05). Conclusion Simple longitudinal incision for tunnel entry, tunnel width≤3 cm and sigmoid type esophagus are risk factors of gas–related complications in POEM, while myotomy depth is not. Key words: Esophageal achalasia; Intraoperative complications; Risk factors; Peroral endoscopic myotomy