Endoscopic findings do not predict per-oral pyloromyotomy (POP) response

Schwalbe, Kathryn; Finelli, Caitlin; Moon, Soon; Niehaus, Hannah; Kondajji, Abhiram; Tu, Chao; Fathalizadeh, Alisan; Kroh, Matthew; Allemang, Matthew T.

doi:10.1007/s00464-022-09321-8

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…The author examined endoscopic findings, such as bile in the stomach, lack of pylorospasm, tight pylorospasm, and very tight pylorospasm, which was not predictive of the G-POEM response. 48 …”

Section: Other Studiesmentioning

confidence: 99%

Gastric peroral endoscopic pyloromyotomy (G-POEM) in patients with refractory gastroparesis: a review

McCurdy

Gooden

Weis

et al. 2023

Therap Adv Gastroenterol

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Gastric peroral endoscopic pyloromyotomy (G-POEM or POP) is an endoscopic therapeutic modality for treatment of refractory gastroparesis. Since the first case reported in 2013, there are more than 200 papers published on G-POEM. In this narrative review, we summarize the short-term and long-term outcomes and review other important studies. The technical success rate is 100% and the short-term (within 1 year) success rate is about 50–80%. The procedure time is between 50 and 70 min while the average length of hospital stay was 2–3 days. The adverse event rate was around 10%. Few patients need further intervention. Three studies showed that at the 4-year follow-up, the response to G-POEM was durable, but there was a yearly recurrence rate of 13% or more. Redo G-POEM is feasible and can be of benefit for some patients. Most of the studies showed that long duration of illness is associated with poor outcomes. However, reliable predictors for successful outcomes are still unknown. Current literature indicates G-POEM is superior to gastric electric stimulator and surgical pyloroplasty. Endoflip has been used at G-POEM to predict the outcome, but the result is very preliminary. A recent sham study confirms the short-term efficacy of G-POEM. G-POEM is safe and about 50% of patients can be discharged to home on the same day. G-POEM allows for direct biopsy of the gastric muscle, which is the location of the pacemaker cells, the interstitial cells of Cajal; therefore, G-POEM may provide a new path for further research on the pathogenesis of gastroparesis.

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Section: Other Studiesmentioning

confidence: 99%

Gastric peroral endoscopic pyloromyotomy (G-POEM) in patients with refractory gastroparesis: a review

McCurdy

Gooden

Weis

et al. 2023

Therap Adv Gastroenterol

View full text Add to dashboard Cite

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Short-term outcomes of gastric per-oral endoscopic pyloromyotomy (G-POEM) then and now: a comparison analysis

Rashid,

Neice,

Mubashir

et al. 2024

Eur Surg

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Summary Background Gastric per-oral endoscopic pyloromyotomy (G-POEM) has been performed for 10 years in the treatment of refractory gastroparesis (Gp). Many studies from the early years of G‑POEM reported short-term outcomes with 60–80% clinical success. Notably, no recent studies have assessed short-term outcomes after a decade of experience with this procedure. In this study, we compare the short-term outcomes of our initial 16 patients undergoing G‑POEM 8 years ago with 16 of our recent patients undergoing G‑POEM. Patients and methods The initial 16 patients who underwent G‑POEM from 06/2015 to 07/2016 (group A; the first 16 G-POEM procedures QC performed) and 16 recent patients who underwent G‑POEM from 07/2021 to 01/2022 (group B; the first 16 procedures performed when QC moved to a different institution) were enrolled in the study. Patients’ demographics, clinical success, procedure time, and length of hospital stay were analyzed and compared between the two groups. All procedures were performed by a single advanced endoscopist (QC). Results Patients’ age, gender, and etiology of gastroparesis were similar between the two groups. There were no differences between the two groups in terms of short-term clinical outcomes. However, there was a significant difference in procedure time and the length of hospital stay between the two groups. There were no adverse events reported for either group A or group B. Conclusion For a single experienced advanced submucosal endoscopist, there were no differences in the short-term clinical outcomes of G‑POEM when comparing the initial timeframe of performing G‑POEM with that after 8 years of experience at the time of the study in a different institution. Notably, the procedure time and the length of hospital stay were significantly shorter after 8 years of practice.

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