ОСЛОЖНЕНИЯ ПЕРОРАЛЬНОЙ ЭНДОСКОПИЧЕСКОЙ МИОТОМИИ. ТРЕХЛЕТНИЙ ОПЫТ ОДНОГО ЦЕНТРА

Aim. To evaluate the number and structure of complications associated with peroral endoscopic myotomy procedure. Materials and methods. Retrospective analysis of 3-year experience of peroral endoscopic myotomy (POEM) for achalasia in one center was performed. The analysis included data of 120 cases. Diagnosis of achalasia was established with the use of water-perfused high-resolution manometer (MMS; Solar GI, Netherlands). Descriptive statistics was used to perform the analysis. Results. Treatment was successful in all 120 cases, mean Eckardt score before and after POEM was 6.2±1.4 and 1.4±0.9, accordingly. The following complications occurred: perforation of mucosa (n=6), suture failure after endoscopic clips application (n=4), submucosal hematoma (n=1). In one case of suture failure it caused mediastinitis, that was managed by toracotomy and drainage of the mediastinum. Other complications were managed by endoscopic methods. Conclusion. POEM is an effective method for achalasia treatment. However, during the operation and in early postoperative period may occur complications that can be treated conservatively or by using minimally invasive procedures.