OBJECTIVE

Evaluate perioperative outcomes and effectiveness of peroral endoscopic myotomy (POEM) for esophageal achalasia in patients with stages II—III and IV in a single hospital setting.

MATERIAL AND METHODS

From 2017 to August 2023, 120 patients aged 15—75 years underwent POEM. Out of these, 100 patients were included in the study, divided into two groups: the first group comprised 84 patients with stages II and III; the second group consisted of 16 patients with stage IV. The duration of the disease ranged from 6 months to 40 years. The study assessed operation time, complications, and quality of life via Eckardt, SF-36, and GIQLI scales.

RESULTS

POEM achieved a 100% technical success rate. No significant differences were noted in operation duration or complication rates between the groups. Both groups reported improved well-being and oral intake. The SF-36 questionnaire revealed significant improvements in the first group in terms of pain intensity, social and role functioning (emotional) 12 months post-operation, while physical and mental health scores remained stable. Improvements were noted in both groups without significant differences on the GIQLI scale. According to the Eckardt scale, both groups showed significant improvement in condition and food intake, with no differences between the groups post-operation.

CONCLUSIONS

POEM in patients with achalasia is the procedure of choice due to its high efficacy and safety profile. Most complications encountered during, and post-surgery were minor or require no intervention. Notably, gastroesophageal reflux, a common postoperative issue, was effectively managed with proton pump inhibitors.