Saudi Gastroenterology Association (SGA) clinical care pathway and standards of care for peroral endoscopic myotomy (POEM) in achalasia

Graphical Abstract Export Peroral endoscopic myotomy (POEM) has become an established, minimally invasive therapy for achalasia, demonstrating high efficacy and safety across all disease subtypes. With its expanding adoption in Saudi Arabia, the Saudi Gastroenterology Association (SGA) developed a clinical care pathway and standards of care to promote safe, consistent, and high-quality practice. The pathway provides evidence-based guidance encompassing all phases of care: preprocedural, intraprocedural, and postprocedural. Key covered aspects include diagnostic evaluation, patient selection, preparation, procedural techniques, documentation, and postprocedural follow up. The document also outlines requirements for endoscopist training and privileges to ensure procedural safety and optimal quality. Quality metrics were formulated to support performance monitoring and continuous improvement across all phases of care. By defining clear standards, this pathway aims to standardize clinical practice, enhance procedural safety, optimize therapeutic outcomes, and elevate the overall quality of care delivered to achalasia patients undergoing POEM.