Gastric per-oral endoscopic myotomy for refractory gastroparesis: a detailed description of the procedure, our experience, and review of the literature

Surg Endosc. 2018 Aug;32(8):3421-3431. doi: 10.1007/s00464-018-6112-5. Epub 2018 Feb 12.

Abstract

Background and aims: Gastric per-oral endoscopic myotomy (G-POEM) was introduced four years ago as an investigational procedure for refractory gastroparesis. The safety and efficacy were currently evaluated. With our recent studies on G-POEM, we share our experience and knowledge through the discussion of a detailed description of the procedure and review of the literature. To our knowledge, this is the first systemic review on this new therapeutic endoscopic procedure.

Methods: The indications and contraindications, various aspects of the procedure, and efficacy assessment are discussed based on our experience and current available data.

Results: Preoperative preparation, detailed description of the procedure, post-procedural care, and results in the literature are presented. The procedure is safe and effective. 70-80% of patients have significant improvement in overall symptoms and quality of life in short-term (6 months) follow-up, as assessed by Gastric Cardinal Symptom Index and Short Form 36.

Conclusions: G-POEM is a feasible and effective procedure for refractory gastroparesis based on early and limited data. Well-designed prospective studies are expected to advance and evaluate this new procedure in the future.

Keywords: G-POEM; Gastroparesis; Per-oral pyloromyotomy.

Publication types

  • Review

MeSH terms

  • Follow-Up Studies
  • Gastroparesis / diagnosis
  • Gastroparesis / surgery*
  • Humans
  • Pyloromyotomy / methods*
  • Quality of Life
  • Treatment Outcome