Minireviews
Copyright ©The Author(s) 2015.
World J Gastrointest Endosc. Oct 10, 2015; 7(14): 1129-1134
Published online Oct 10, 2015. doi: 10.4253/wjge.v7.i14.1129
Table 1 Complications after peroral endoscopic myotomy
ComplicationTreatment
Mucosal injuryAfter completion of myotomy, mucosal defects should be closed to minimize risk of leak with clips or suturing device
Full thickness injuryAlthough certain centers have demonstrated safety with full thickness myotomy, if occurs at site of mucosectomy the operator must consider closure of this myotomy site to prevent potential leakage
Gas escape related complications
Subcutaneous emphysemaObservation
PneumomediastinumObservation, unless physiologic symptoms
PneumothoraxSmall volume closely observed with oxygen only. Volume > 30% may require decompression
PneumoperitoneumLarge volume or physiologic symptoms requires decompression of the abdomen with Veress needle insertion
Pleural effusionSmall volume can be observed and will absorb. Larger volumes with symptoms require drainage
BleedingMost common at the GEJ or distal on stomach side due to increased vascularity. Supportive care and transfusions, endoscopic re-exploration if warranted for hemostasis
Leak/mediastinitisDepending on time of presentation and extent of perforation will determine the interventions required, which may be as simple as endoscopic treatment or as severe as invasive surgical treatment