title: The last innovation in achalasia treatment; per-oral endoscopic myotomy.
abstract: OBJECTIVE
  Per-oral endoscopic myotomy (POEM) is a minimally invasive endoscopic treatment option for patients with achalasia and has been performed since 2010. It is less invasive than Heller myotomy and its use is spreading rapidly worldwide. We present our results of POEM that, to the best of our knowledge, are the first cases in Turkey.
  
  
  METHODS
  We enrolled patients between May 2014 and September 2014; 8 patients with achalasia whose complaints recurred after pneumatic balloon dilatation underwent POEM. The procedure was performed under general anesthesia at the endoscopy unit of the gastroenterology clinic. Demographic data was recorded before the procedure, and the results of the procedure were recorded prospectively.
  
  
  RESULTS
  The median age of the patients was 42.5 (30-72) years. Preoperative and postoperative median Eckardt scores were 10 (8-12) and 1 (0-2), respectively. The median total duration of the procedure was 101 (71-158) min, and the median myotomy length was 13.5 (10-16) cm. Postoperative oral intake started on median day 1 (1-2) and the length of hospital stay was 4 (3-6) days. In 2 patients, capnoperitoneum developed during the procedure and was treated with a Veress needle.
  
  
  CONCLUSIONS
  POEM is a safe endoscopic treatment modality for patients with achalasia in centers that are experienced in advanced endoscopic techniques.
authors.affiliation: Department of Gastroenterology, Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey. drfatihaslan@hotmail.com.
authors.forename: Fatih
authors.initials: F
authors.lastname: Aslan
authors.forename: Zehra
authors.initials: Z
authors.lastname: Akpınar
authors.forename: Emrah
authors.initials: E
authors.lastname: Alper
authors.forename: Aynur
authors.initials: A
authors.lastname: Atay
authors.forename: Derya Aslan
authors.initials: DA
authors.lastname: Yurtlu
authors.forename: Cem
authors.initials: C
authors.lastname: Çekiç
authors.forename: Serhat
authors.initials: S
authors.lastname: Bor
authors.forename: Belkis
authors.initials: B
authors.lastname: Ünsal
mesh_terms: D000328:Adult; D000368:Aged; D004931:Esophageal Achalasia / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009055:Mouth; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D061646:Operative Time; D011446:Prospective Studies; D014421:Turkey