Background: Per-oral esophageal myotomy endoscopic (E-POEM) has clearly proved safety and efficiency in the treatment of esophageal spastic disorders. Recent studies on endoscopic pyloromyotomy (G-POEM) suggest good efficiency and safety in the treatment of gastroparesis. In recent literature, some reports showed both esophageal motility disorders and gastroparesis.

Methods: We report the case of four patients with esophageal and gastric motility disorders who were successfully treated with DUAL POEM (E-POEM and G-POEM) in two separate procedures.

Results: Clinical improvement was reported in all patients with a decrease of the Eckardt score for esophageal motility disorders and a decrease of the GCSI score for gastroparesis. No adverse events occurred after any procedure. These reported cases suggest that is possible to perform an E-POEM and a G-POEM in the same patient in two distinct procedures.

Conclusions: DUAL POEM seems to be faisable in patient with esophageal motility disorders associated with gastroparesis. The possibility of the concomitant occurrence of esophageal and gastric motility disorders could lead to change in practices with an overall assessment including gastric empting scintigraphy, high resolution manometry and pH-impedancemetry for patients with digestive motility disorders.

背景：经口食管肌切开术内镜（E-POEM）已明确证明在治疗食管痉挛性疾病中的安全性和有效性。内窥镜幽门切开术（G-POEM）的最新研究表明，在治疗胃轻瘫中有良好的效率和安全性。在最近的文献中，一些报道同时显示了食道运动障碍和胃轻瘫。

方法：我们报告了四例食管和胃动力异常的患者，他们在两个单独的过程中成功接受DUAL POEM（E-POEM和G-POEM）治疗。

结果：据报道，所有患者的食管运动障碍性疾病的Eckardt评分降低，而胃轻瘫的GCSI评分降低，所有患者均出现临床改善。任何手术后均未发生不良事件。这些报道的病例表明，可以通过两种不同的方法对同一名患者进行E-POEM和G-POEM。

结论： DUAL POEM在伴有胃轻瘫的食管运动障碍患者中似乎可行。食管和胃动力障碍同时发生的可能性可能会导致实践的变化，包括消化道动力障碍患者的整体评估包括胃排空闪烁显像，高分辨率测压和pH阻抗测定。