Abstract
Endoscopic tunnel technique divides deliberately the wall of digestive tract into two-layer with the establishment of submucosal tunnel to ensure a safe barrier to prevent concerned serious complications in treatment of lesions from mucosa or muscularis propria. Even so, some complications might emerge inevitably. The most common complications are pneumatosis-related complications, including subcutaneous emphysema, mediastinal emphysema, pneumoperitoneum, and even pneumothorax. Mucosal perforation also happen occasionally, the incidence of which is 3.6–20 %. Hemorrhage, intraoperative or delayed, cannot be ignored in spite of its relatively low incidence. Gastroesophageal reflux is one of the most concerned complications of POEM, which influences the quality of life of the patients. Infection is one of most serious complications after operation, such as mediastinitis, peritonitis, pulmonary infection. Esophageal stricture is a major problem for patients with large esophageal mucosal lesions treated with tunnel technique, the incidence of which is closely related to length and circumferential area of lesions.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Inoue H, Ikeda H, Hosoya T. Submucosal endoscopic tumor resection for subepithelial tumors in the esophagus and cardia. Endoscopy. 2012;44(3):225–30.
Xu MD, Cai MY, Zhou PH, et al. Submucosal tunneling endoscopic resection: a new technique for treating upper GI submucosal tumors originating from the muscularis propria layer (with videos). Gastrointest Endosc. 2012;75(1):195–9.
Xu MD, Lu W, Li QL, et al. Application and evaluation of submucosal tunneling endoscopic resection of gastric submucosal tumors originating from the muscularis propria layer. Zhonghua Wei Chang Wai Ke Za Zhi. 2012;15(7):671–4.
Zhao ZF, Ma SR, Zhang N, et al. Endoscopic esophageal submucosal tunnel resection of gastric fundus-cardiac tumors originating from muscularis propria. Chin J Dig Endosc. 2012;29(9):506–9.
Swanström LL, Rieder E, Dunst CM. A stepwise approach and early clinical experience in peroral endoscopic myotomy for the treatment of achalasia and esophageal motility disorders. J Am Coll Surg. 2011;213(6):751–6.
Costamagna G, Marchesea M, Familiari P, et al. Peroral endoscopic myotomy (POEM) for oesophageal achalasia: preliminary results in humans. Dig Liver Dis. 2012;44(10):827–32.
Von Renteln D, Inoue H, Minami H, et al. Peroral endoscopic myotomy for the treatment of achalasia: a prospective single center study. Am J Gastroenterol. 2012;107(3):411–7.
Zhou PH, Cai MY, Yao LQ, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Chin J Dig Endosc. 2011;28(2):4–7.
Ren Z, Zhong Y, Zhou P, et al. Perioperative management and treatment for complications during and after peroral endoscopic myotomy (POEM) for esophageal achalasia (EA) (data from 119 cases). Surg Endosc. 2012;26(11):3267–72.
Linghu E, Li H, Feng X, et al. Efficacy and safety of transverse entry incision during peroral endoscopic myotomy for achalasia. Chin J Dig Endosc. 2012;29(9):483–6.
Minami H, Isomoto H, Yamaguchi N, et al. Peroral endoscopic myotomy for esophageal achalasia: clinical impact of 28 cases. Dig Endosc. 2013 Apr 14. doi: 10.1111/den.12086. [Epub ahead of print].
Li H, Linghu E, Wang X. Fibrin sealant for closure of mucosal penetration at the cardia during peroral endoscopic myotomy (POEM). Endoscopy. 2012;44:E215–6.
Inoue H, Tianle KM, Ikeda H, et al. Peroral endoscopic myotomy for esophageal achalasia: technique, indication, and outcomes. Thorac Surg Clin. 2011;21(4):519–25.
Gao X, Shan H, Li Y, et al. Application of submucosal tunneling endoscopic resection for early esophageal cancer and precancerous lesions. J Clin Surg. 2012;20(7):491–2.
Ono S, Fujishiro M, Niimi K, et al. Long-term outcomes of endoscopic submucosal dissection for superficial esophageal squamous cell neoplasm. Gastroinest Endosc. 2009;70(5):860–6.
Yamashina T, Ishihara R, Uedo N, et al. Safety and curative ability of endoscopic submucosal dissection for superficial esophageal cancers at least 50 mm in diameter. Dig Endosc. 2012;24(4):220–5.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Linghu, E. (2014). Prevention and Treatment for Complications of Endoscopic Tunnel Technique. In: Linghu, E. (eds) Therapeutics of Digestive Endoscopic Tunnel Technique. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7344-8_9
Download citation
DOI: https://doi.org/10.1007/978-94-007-7344-8_9
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-007-7343-1
Online ISBN: 978-94-007-7344-8
eBook Packages: MedicineMedicine (R0)