OBJECTIVE

Evaluation of peroral endoscopic myotomy (POEM) results in the treatment of patients with esophageal achalasia at a single center.

MATERIAL AND METHODS

In the period from 2017 to August 2022, POEM were performed in 100 patients aged 15 to 75 years (mean age, 53 years) (women, 64; men, 36). The duration of the disease ranged from 6 months to 40 years.

RESULTS

An analysis was done on the operation time, the extent of the myotomy, and the frequency of adverse events (in the intraoperative and postoperative periods). The technical success of the interventions was 99%. A posterior approach had a shorter operation time (p=0.000189). The total operation time in patients who had previous interventions was significantly higher than in patients who hadn’t been treated (p=0.005404). In two patients, a second mucosal incision was performed due to submucosal layer fibrosis. Perforation (3.03%) and hemorrhage (2.02%) are the two intraoperative complications that occur most frequently. Postoperative period complications amounted to 4.04%. The adverse effects during the operation and in the postoperative period were treated. Oral food intake was restored in all patients. The mean value of the Eckardt scale after intervention was 1.48. Complaints after POEM had 27 patients.

CONCLUSION

POEM is the gold standard treatment for achalasia due to its high efficiency and safety profile. Complications during the intervention and in the postoperative period can be easily eliminated in most cases. The high frequency of gastroesophageal reflux is the most common complication of the postoperative period and can be treated with proton pump inhibitors with a good clinical effect.