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

Background: Peroral endoscopic myotomy (POEM) is a novel endoscopic technique for the treatment of achalasia. However, there are POEM-associated complications, the most common of which being gas-related. The aim of the current study was to determine the occurrence of and risk factors for gas-related complications of POEM in patients with achalasia. Methods: Retrospective analyses were performed on the clinical data of 216 achalasia patients receiving POEM at our hospital during the period from August 2011 to November 2013. Univariate and multivariate analyses were conducted to look for potential risk factors for gas-related complications. Results: The rate of gas-related complications was 10.2% (22/216). Univariate analyses indicated that simple longitudinal mucosal incision, tunnel width <= 3 cm, sigmoid-type oesophagus, myotomy depth and operative time were risk factors for gas-related complications (p < 0.05). Multivariate analyses indicated that simple longitudinal mucosal incision, tunnel width <= 3 cm and sigmoid-type oesophagus were risk factors for the complications (p < 0.05). Conclusions: Simple longitudinal mucosal incision, tunnel width <= 3 cm and sigmoid-type oesophagus are independent risk factors for gas-related complications for achalasia during POEM, but not myotomy depth and operative time.