The hypothesis of this study is to investigate cardiorespiratory and renal complications in patients under general anesthesia undergoing POEM surgery.

The primary purpose of this study is to define mild, medium and severe risk groups for malnutrition by using preoperative albumin values and MUST score in achalasia patients planned for POEM operation, and to determine the relationship of malnutrition/degree as well as demographic characteristics and comorbidities with postoperative respiratory and renal complications.

The secondary aim of this study was to determine persistent respiratory and renal outcome at 3 months after POEM procedure.

Inclusion Criteria:

• Criteria for inclusion in the study:
• Patients diagnosed with achalasia and suitable for POEM treatment by gastroenterology physicians
• ASA 1-3
• Between the ages of 18-80

Exclusion Criteria:

• Criteria for exclusion from the study:
• Those with a known history of active lung infection, advanced COPD, or respiratory failure
• Patients with EF below 40%, severe ischemic heart failure, presence of valve disease
• Those with bleeding diathesis and severe thrombocytopenia (limit 30-50 thousand)
• severe kidney dysfunction
• In the presence of known intolerance or allergy to certain medications for sedation, analgesia, or both
• Pre-existing increased intracranial pressure
• Having a BMI >30
• Severe uncorrected hypovolemiaHistory of radiotherapy to the esophagus
• History of mucosal resection or ablation in the area where POEM will be applied
• Presence of cirrhosis and portal hypertension.

In this retrospective cohort study, 50 patients diagnosed with achalasia who applied to the Gastroenterology department of Ümraniye Training and Research Hospital between October 2021 and February 2024 and were indicated for POEM treatment will be included.