Background Esophageal motility disorders which include achalasia, esophagogastric junction outflow obstruction (EGJ outflow obstruction), jackhammer esophagus (JE), distal esophageal spasm (DES), etc. are rare disease of unknown causes. The diagnosis is based on endoscopy, barium meal, and high-resolution manometry (HRM). With the development of endoscopy, peroral endoscopic myotomy (POEM) has emerged as a standard method for the treatment of achalasia. Purpose The purpose of this article is to enable gastroenterologists to have a more comprehensive understanding of the application status, technical characteristics, clinical efficacy and future prospect of POEM in the treatment of esophageal motility disorders. Methods Through a large number of reading literature, combined with clinical practice, summary and analysis of the indications, procedure, efficacy, complications, and controversies of POEM in the treatment of esophageal motility disorders, as well as the current and future perspectives of POEM were studied. Results POEM is safe and effective in the treatment of esophageal motility disorders, but the GERD reflux rate is higher. Conclusions POEM can be a new option for the treatment of esophageal movement disorders, but large sample, multi-center, long-term study reports are needed, and it promotes the development of NOTES technology.

In the past 20 years, several magnetically controlled capsule endoscopes (MCCE) have been developed for the evaluation of gastric lesions, including NaviCam (ANKON), MiroCam-Navi (Intromedic), Endocapsule MGCE (Olympus and Siemens), SMCE (JIFU), and FAMCE (Jinshan). Although limited to observing esophageal and duodenal lesions and lacking the ability of biopsy, MCCE has the advantages of comfort, safety, no anesthesia, no risk of cross-infection, and high acceptability. Several high-quality RCTs showed that the diagnostic accuracy of MCCE is comparable to the traditional gastroscopy. Due to the nonnecessity of anesthesia, MCCE may be more suitable for the elderly with obvious comorbidities as well as children. With more evidences accumulated and more innovative technologies developed, MCCE is expected to be an important tool for screening of early gastric cancer or the diagnosis of gastric diseases.

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Gastrointestinal leiomyosarcoma remains relatively rare,accounting for only 1% of gastric tumors,since the use of c-kit staining was first described in 1998 to differentiate gastrointestinal stromal tumors.In this case report,we described the clinical manifestations,endoscopic features, and pathological immunohistochemical features of the gastric leiomyosarcoma.We found that endoscopic ultrasonography has great value in the diagnosis of gastric leiomyosarcoma,and that minimally invasive endoscopic treatment is safe and effective.Particularly,this case highlights that the early-stage lesions can be treated with minimally invasive endoscopic treatment with good tolerance and satisfactory clinical results.Endoscopic submucosal dissection is thus effective for treating gastric leiomyosarcoma,with promising prospects for clinical application.

Background. Magnetically controlled capsule endoscopy has been shown to be feasible for the examination of gastric diseases. However, there may be problems, such as low image quality, incomplete esophageal observation, and capsule retention. We developed a novel magnetically controlled cable capsule endoscopy (MCCCE) system and evaluated its feasibility through in vitro experiments. Methods. Three experienced endoscopists performed MCCCE on the plastic stomach model and the excised porcine stomach model 5 times, respectively. Outcomes included handle ability, examination time, examination completion, and image quality. The examination completion was accessed by other two blinded endoscopists, and the image quality was compared with conventional gastroscopy (Olympus, GIF-290). Results. The performance of MCCCE in vitro experiments is excellent, with a mean operation time of 18.5 minutes in the plastic stomach model and 17.3 minutes in the excised porcine stomach model. The visualization rate of the gastric mucosa is >90% in the plastic stomach model and 75–90% in the excised porcine stomach model. The images of MCCCE are very clear, with good color resolution and no image distortion, which seem to be comparable to conventional gastroscopy. Conclusions. MCCCE system is feasible for gastric examination in vitro experiments, living animal experiments and human trials need to be further conducted.