Michal Demeter, Peter Bánovčin, Martin Ďuríček, Rastislav Kunda, Rudolf Hyrdel
POEM (peroral oesophageal endoscopic myotomy) is a new endoscopic therapeutic method in therapy of achalasia. It
is based on tunnelisation of submucous space in the distal oesophagus, lower oesophageal sphincter and cardia, selective
myotomy of circular muscles in distal oesophagus, lower oesophageal sphincter and total myotomy in cardia. We
treated 15 patients with achalasia with POEM method in University Hospital Martin from March 2015. All procedures
were performed without any serious perioperative complications. The second day after the procedure we diagnosed
a leak of contrast material in the entry point to submucosa during routine oesophageal X-ray. In one patient there was
a leak of contrast material in the area of LES due to exulceration of mucus membrane on the 15th postoperative day.
All oesophageal leaks closed after placement of nasogastric tube and antibiotic therapy. POEM is an effective and safe
endoscopic therapeutic method.