Tu1174 CLICICAL AND ENDOSCOPIC PREDICTORS FOR INTRAPROCEDURAL MUCOSAL PERFORATION DURING PERORAL ENDOSCOPIC MYOTOMY: A RETROSPECTIVE SINGLE CENTER STUDY

Abstract

Mucosal perforation is the most critical perioperative adverse event of peroral endoscopic myotomy (POEM). Severe mucosal perforation may cause contamination of the tunnel and lengthen hospital stay. This study explored the characteristics, predictors, and management approaches for Mucosal Perforation. POEM was successfully performed in 211 patients. A total of 44 patients experienced mucosal perforation, for an overall frequency of 20.8% (44/211). On multivariable analysis, Mucosal perforation was associated with previous POEM history (odds ratio [OR], 9.343; P = 0.04), submocosal fibrosis (OR, 6.3; P=0.084), Intraprocedure bleeding (OR, 16.904; P<0.001), large-caliber endoscope (OR, 3.772; P =0.035), and long procedure duration (OR, 0.016; P<0.034). Mucosal perforation is a significant complication encountered during POEM procedure. Previous POEM, Procedure duration, Intraprocedure bleeding and caliber diameter were significant predictors of Mucosal perforation. As endoscopists give more attention to the bleeding and use small diameter endoscope, the incidence of mucosal perforation may be reduced.