INTRODUCTION Per-oral endoscopic myotomy (POEM) is effective in achalasia. The objective of this study was to evaluate the short-term clinical efficacy of POEM in non-achalasia esophageal motility disorders (NAEMD). PATIENTS AND METHODS Patients with NAEMD diagnosed by high-resolution manometry were included in a retrospective multicentric study. For each individual case, two controls paired on gender and age were matched: one with type I/II achalasia and one with type III achalasia. The clinical response, defined by an Eckardt score ≤ 3, was assessed at 3 and 6 months. RESULTS Ninety patients (mean age 66 years, 57 men) were included, 30 patients with NAEMD (13 jackhammer esophagus, 6 spastic esophageal disorders, 4 nutcracker esophagus, and 7 esophagogastric junction obstruction), 30 patients with type I-II achalasia, and 30 patients with type III achalasia. The 3-month response rates were 80% (24/30), 90% (27/30), and 100% (30/30) in NAEMD, type I-II achalasia and type III achalasia, respectively (p < 0.01). Eckardt scores improved from preoperative baseline in all groups (median scores 2.0 after POEM vs. 6.5 before POEM, 1.3 vs. 7.2, and 0.5 vs. 6.1 in NAEMD, type I//I and Type III, respectively). No predictive factor of response was identified. In NAEMD patients, there was a significant improvement of dysphagia, regurgitation, and chest pain scores. The 6-month response rates were 63.2% (12/19), 95.5% (21/22), and 87.0% (20/23) in NAEMD, type I-II achalasia and type III achalasia, respectively (p = 0.03). CONCLUSION Although less effective than in achalasia, POEM is an effective treatment for NAEMD. Long-term follow-up data are needed to further confirm that POEM may be a valid treatment of NAEMD.

中文翻译：

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经口内镜下肌切开术治疗非-门失弛缓性食管运动障碍的疗效。

引言经口内镜下肌切开术（POEM）在门失弛缓症中有效。这项研究的目的是评估POEM在非ach门失弛缓性食管运动障碍（NAEMD）中的短期临床疗效。患者和方法经回顾性多中心研究纳入了通过高分辨率测压法诊断为NAEMD的患者。对于每例病例，配对配对了两个性别和年龄的对照：一个患有I / II型门失弛缓症，另一个患有III型type门失弛缓症。在3个月和6个月时评估由Eckardt评分≤3定义的临床反应。结果包括90例患者（平均年龄66岁，男性57例），30例NAEMD患者（13手提刀食道，6例痉挛性食管疾病，4例胡桃夹子食道和7例食管胃连接障碍），30例I-II型门失弛缓症患者，30例III型失语症患者。NAEMD，I-II型门失弛缓症和III型门失弛缓症的3个月缓解率分别为80％（24/30），90％（27/30）和100％（30/30）（p <0.01） 。所有组的Eckardt评分均较术前基线有所改善（POEM后中位数分别为2.0，POEM前为6.5，NAEMD I // I和III型分别为1.3与7.2、0.5与6.1）。未确定反应的预测因素。在NAEMD患者中，吞咽困难，反流和胸痛评分显着改善。NAEMD，I-II型门失弛缓症和III型门失弛缓症的6个月缓解率分别为63.2％（12/19），95.5％（21/22）和87.0％（20/23）（p = 0.03） 。结论虽然POEM疗效不及门失弛缓症，但它是NAEMD的有效治疗方法。