Gastric peroral endoscopic pyloromyotomy for refractory gastroparesis: a systematic review of early outcomes with pooled analysis

Marco Spadaccini, Roberta Maselli, Viveksandeep Thoguluva Chandrasekar, Andrea Anderloni, Silvia Carrara, Piera Alessia Galtieri, Milena Di Leo, Alessandro Fugazza, Gaia Pellegatta, Matteo Colombo, Rossella Palma, Cesare Hassan, Amrita Sethi, Mouen A. Khashab, Prateek Sharma, Alessandro Repici

Research output: Contribution to journalReview article

Abstract

Background and Aims: Gastroparesis (GP) is a chronic debilitating condition. Prior pyloric-targeted procedures are either invasive or have questionable efficacy. Gastric peroral pyloromyotomy (G-POEM) has been proposed as a minimally invasive approach. We performed a pooled analysis to evaluate the efficacy and safety of G-POEM for GP. Methods: Electronic databases (Medline, Scopus, EMBASE) were searched up to January 2019. Studies including patients who underwent G-POEM for GP were eligible. Procedural, clinical, and safety outcomes were assessed by pooling data with a random- or fixed-effect model according to the degree of heterogeneity to obtain a proportion with a 95% confidence interval. Results: Ten studies were eligible for inclusion (292 patients), and 2 of the 10 studies were prospective. Seven studies were performed in the United States, 2 in France, and 1 in China. Endoscopic pyloromyotomy was feasible in all patients. Significant symptomatic improvement was achieved after 83.9% of procedures (mean follow-up, 7.8 ± 5.5 months). When comparing the mean values of pre- and postprocedural scintigraphic evolution, there was a significant decrease of the residual percentage at 2 and 4 hours. The overall adverse events rate was 6.8%. Conclusions: G-POEM appears to be a promising approach for GP in terms of safety and efficacy outcomes in the short term.

Original languageEnglish (US)
Pages (from-to)746-752.e5
JournalGastrointestinal endoscopy
Volume91
Issue number4
DOIs
StatePublished - Apr 2020

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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    Spadaccini, M., Maselli, R., Chandrasekar, V. T., Anderloni, A., Carrara, S., Galtieri, P. A., Di Leo, M., Fugazza, A., Pellegatta, G., Colombo, M., Palma, R., Hassan, C., Sethi, A., Khashab, M. A., Sharma, P., & Repici, A. (2020). Gastric peroral endoscopic pyloromyotomy for refractory gastroparesis: a systematic review of early outcomes with pooled analysis. Gastrointestinal endoscopy, 91(4), 746-752.e5. https://doi.org/10.1016/j.gie.2019.11.039