Recently, the Department of Gastroenterology successfully performed through transoral endoscopic myotomy (POEM) surgery on two patients with cardia achalasia who had failed Heller surgery. One of the patients, Ms. Zhi, had swallowing difficulties for 18 years. 11 years ago, she was clearly diagnosed with cardia achalasia in an external hospital and underwent cardia esophageal myotomy (Heller), but her swallowing difficulties were not significantly relieved after the operation. 7 years ago, she underwent Heller again in an external hospital and still felt difficulty in swallowing after the operation. Later, he underwent balloon dilatation, but his symptoms did not improve significantly. He was admitted to our gastroenterology department in October 2014 due to reflux after eating, retrosternal pain and sharp weight loss, and gastroscopy revealed heterogeneous hyperplastic lesions in the lower esophagus. On October 29, Deputy Director of Gastroenterology Yonghui Huang successfully performed POEM on the patient. The patient had no complications such as bleeding and perforation after surgery, and the dysphagia improved significantly after eating and was discharged smoothly. The main symptoms are dysphagia, regurgitation, vomiting, heartburn, chest pain and weight loss, and aspiration of regurgitant may also cause respiratory symptoms, which seriously affects the quality of life of patients. The esophageal mucosa can become inflamed, ulcerated or even cancerous due to long-term food irritation, so timely and effective treatment is needed. The current treatment goal is to relieve symptoms, including myorelaxant medication, endoscopic injection of botulinum toxin, probe and balloon dilation, stent placement, and thoracic surgery cardia-esophageal myotomy Heller procedure. 2010, POEM was first reported abroad for patients with cardia incontinentia, which involves endoscopic incision of the esophageal mucosal layer, separation of the submucosal layer, and establishment of a submucosal tunnel. The cricoid muscle is cut to relax the cardia sphincter to achieve symptomatic relief. The Department of Gastroenterology has been performing POEM since 2012, and has performed POEM on more than 50 patients with cardia achalasia with satisfactory short-term clinical outcomes.