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Chapter 4
Conclusion
In the absence of controlled studies in patients with achalasia and a limited anaesthesiologic
experience of POEM, it is not possible to make strong recommendations. The methods
as described above seem to provide an effective and safe treatment option. We strongly
recommend a strict fasting protocol in patients with achalasia and measures to prevent
aspiration, such as RSI. The preprocedural ‘cleaning’ oesophago-gastroscopy seems not to
be necessary and is probably very uncomfortable for the patient.