Per Oral Endoscopic Myotomy in Treatment of Moroccan Patients with Achalasia: Prelimanary Result

Abstract

Background and Objectives: Endoscopic myotomy is a recent technique that did spread quickly across high-income countries. The aim of this study is to report the experience of our department regarding the practice of POEM. Study design: It is a retrospective study including 13 patients with achalasia treated by POEM at the Department of Digestive Functional Explorations (EFD-HGE) of University Hospital Center Ibn Sina of Rabat, between January 2017 and June 2023. There was a break during the COVID19 pandemic and the endoscopic activity was stopped for a while. Results: The median age was 40, 46. Women were more affected than men: 69% and 31% respectively. Only 15% of cases had previous treatment (pneumatic dilation/surgical myotomy). The clinical success rate reached 84.6%. The mean of Eckardt scores decreased from 8 at baseline to 3 at 2 months. The IRP’s mean decreased from 23.9 mmHg to 15.6 mmHg after the gesture. The post-POEM reflux rate was less than 16%, but the rate of serious adverse events was relatively high. Conclusions: POEM is an effective procedure to treat achalasia with a low morbidity, provided that it is carried out in an expert center with suitable and good quality material.