TP6.2.14 Outcome of POEM (Per-oral endoscopic myotomy) for achalasia

Abstract Aims Laparoscopic Heller’s myotomy (LHM) has been the surgical gold standard for treatment of oesophageal achalasia. Peroral endoscopic (POEM) proposed as an alternative technique. The aim this study was to assess safety and efficacy POEM achalasia in our unit. Methods We have operated on 202 patients since 2005: 107 had LHM, 86 POEM, 9 oesophagectomy. assessed clinical outcome comparing pre- postoperative endoscopic, radiologic manometric findings, well Eckardt-, GERD- DsQoL score All follow-up were offered endoscopy. Results Data completed first 45 patients. average age years. 18 (40%) prior treatment. median hospital stay 2 days (2-5). There no mortality, but 4 (9%) post-operative complications. 24 months (12-49). Clinical success (Eckardt ≤ 3) achieved 39 (87%). Thirteen (29%) taking PPIs chest symptoms. Eleven these underwent pH studies whom only 1 a DeMeester > 14.5. Of who endoscopy, 40% diagnosed with oesophagitis grade A, yet 5 them symptomatic. Conclusions appears be safe effective warrants consideration first-line therapy expert centres. Longer term randomized outcomes LHM pneumatic dilatation will determine its place