G‐POEM with antro‐pyloromyotomy for the treatment of refractory gastroparesis: mid‐term follow‐up and factors predicting outcome

Abstract

The mid-term efficacy of G-POEM reaches 70% at 6 months. The procedure remains reproducible and safe. Diabetes and female gender were predictive of failure.

Peroral endoscopic pyloromyotomy for gastroparesis: a systematic review and meta-analysis

“…Among the 10 studies included in this meta-analysis, four were prospective [19][20][21][22], including two published abstracts [20,21], and 6 were retrospective [1,[23][24][25][26][27], including also another abstract [27], which we chose instead of the published article from the same group, because it is more recent and has a larger number of patients [28]. In total, 281 patients were included in this meta-analysis.…”

“…Using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Series quality assessment, all 10 studies did not clearly report the demographics of the participants. Five studies did not report clear information about the participants [20][21][22][23]27] and two were unclear [25,26] The Hustak et al [20] study was the only one that did not report clear information about the site/clinic demographic information. Quality assessment is shown in ▶ Table 2.…”

“…The Xue et al [20] study was not included in this subgroup analysis because the results were described at the 1month follow up. Gonzalez et al [25], Hustak et al [20], Landreneau et al [1], Malik et al [24], Jacques et al [22], Hernandez Mondragon et al [21] and Rodriguez et al [19] reported the mean difference between GCSI before and after 3 months of G-POEM with a 95 % confidence interval as 1.76 [1.26-2.25] by the Cochran Q test (P < 0.0001, I 2 = 81 %). Although the hetero-geneity was high, all the studies showed improvement in the GCSI score after the procedure.…”

“…7). However, the follow-up duration was quite heterogeneous across all studies, varying from 1 to 24 months; therefore, we calculated the clinical success rate with the longest follow-up data available provided in seven studies [20][21][22][23][24][25]27]. We included one published abstract in this meta-analysis, from Hustak et al [20], that has the longest follow-up period, where one woman from a total of seven patients included had finished the 24-month follow up and maintained an excellent outcome (mean GCSI: 0.77).…”

“…However, unfortunately, we could not in-▶ clude this last result in our analysis because it did not have the calculated SD values. All the studies but one showed a significant reduction in the total GCSI after G-POEM [1,[19][20][21][22][23][25][26][27]. This lack of significant change in the GSCI values might have been due to its lower GCSI values before the procedure and it may be the reason why Malik et al [24] is represented as an outlier.…”