Comprehensive Analysis of Adverse Events Associated with Gastric Peroral Endoscopic Myotomy: An International Multicenter Study

Y. Ichkhanian, K. Vosoughi, M. Aghaie Meybodi, J. Jacques, A. Sethi, A. A. Patel, A. A. Aadam, J. R. Triggs, A. Bapaye, S. Dorwat, P. Benias, D. M. Chaves, M. Barret, R. J. Law, N. Browers, M. Pioche, P. V. Draganov, A. Kotzev, F. Estremera, E. AlbenizM. B. Ujiki, Z. M. Callahan, I. M. Itani, O. G. Brewer, M. A. Khashab*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: 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. Methods: 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. Results: 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). Conclusion: 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.

Original languageEnglish (US)
JournalSurgical endoscopy
DOIs
StateAccepted/In press - 2020

Keywords

  • Adverse events
  • G-POEM
  • Gastric peroral endoscopic myotomy
  • Gastroparesis

ASJC Scopus subject areas

  • Surgery

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    Ichkhanian, Y., Vosoughi, K., Aghaie Meybodi, M., Jacques, J., Sethi, A., Patel, A. A., Aadam, A. A., Triggs, J. R., Bapaye, A., Dorwat, S., Benias, P., Chaves, D. M., Barret, M., Law, R. J., Browers, N., Pioche, M., Draganov, P. V., Kotzev, A., Estremera, F., ... Khashab, M. A. (Accepted/In press). Comprehensive Analysis of Adverse Events Associated with Gastric Peroral Endoscopic Myotomy: An International Multicenter Study. Surgical endoscopy. https://doi.org/10.1007/s00464-020-07570-z