Efficacy and safety of gastric peroral endoscopic myotomy (G-POEM) for refractory gastroparesis: 3-year follow up results.
Journal
Journal of the Formosan Medical Association = Taiwan yi zhi
Journal Volume
121
Journal Issue
7
Pages
1334 - 1341
ISSN
0929-6646
Date Issued
2022-07
Author(s)
Chung, Chen-Shuan
Huang, Tien-Yu
Lin, Cheng-Lu
Chiang, Chen-Han
Chen, Kuan-Chih
Wu, Jiann-Ming
Chen, Kuo-Hsin
Lee, Tzong-Hsi
Lin, Cheng-Kuan
Abstract
Background/Purpose: Gastroparesis is a common but easily overlooked disease. Gastric peroral endoscopic myotomy (G-POEM) is one of the third-space endoscopy techniques to treat gastroparesis. In this study, we aimed to evaluate the efficacy and safety of G-POEM for patients with refractory gastroparesis. Methods: Between December 2017 and 2020, we consecutively enrolled patients with gastroparesis who failed after the administration of several kinds of medication and repeated admission for nutritional support. All patients underwent gastric emptying scintigraphy and answered a questionnaire on Gastroparesis Cardinal Symptom Index (GCSI). Demographic data, endoscopic procedure, and post procedural outcome were analyzed. Results: A total of 11 (9 women and 2 men) patients with refractory gastroparesis (nine with diabetes mellitus, one systemic lupus erythematosus, and one idiopathic) were enrolled. The mean (±standard deviation (SD)) procedure time was 61.82 (±18.99) min with technical and clinical success rates of 100% and 81.82%, respectively. A statistically significant improvement was observed in the clinical severity (mean GCSI score 36.00 vs. 14.73, p < 0.0001) and gastric emptying time (mean T1/2 341.92 vs. 65.92 min, p = 0.016) after G-POEM. Hospital stay was 7.18 (±4.49) days without mortality. Complications included 4 (36.36%) patients with self-limited postprocedural abdominal pain and 3 (27.27%) patients with intra-procedural pneumoperitoneum. During the mean follow-up period of 554.36 days, one (9.09%) patient had relapsed clinical symptoms after 6 months. Conclusion: G-POEM is an efficient and safe pylorus-directed endoscopic therapy for refractory gastroparesis with promising results. © 2021 Formosan Medical Association
Subjects
Functional GI disorder
Gastroparesis
Peroral endoscopic myotomy
Third-space endoscopy
SDGs
Type
journal article