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OBJECTIVES This study compared the safety and efficacy of peroral endoscopic myotomy for esophageal motility disorders between octogenarians and non-octogenarians. METHODS This retrospective observational study recruited 321 patients (28 octogenarians and 293 non-octogenarians) who underwent peroral endoscopic myotomy from two institutions. Clinical success (postoperative Eckardt score≤3), technical success (completion of gastric and esophageal myotomy), and perioperative adverse events were compared between octogenarians and non-octoge