Abstract
Gastric Per-oral Endoscopic pyloromyotomy (G-POEM) or per-oral pyloromyotomy (POP) is a novel procedure recently described for treatment of medically refractory gastroparesis; however, its efficacy and safety is not clear in patients with postsurgical gastroparesis (PsGP). We conducted a systematic review and meta-analysis to determine the efficacy and safety of G-POEM in PsGP. A total of 6 studies were included in the analysis. The pooled rate of success by gastroparesis cardinal symptom index (GCSI) and 4-h gastric emptying study (GES) were 89.6% (95% C.I. 72.7–96.5) and 81.5% (95% CI 47.8–95.5) respectively. There was a statistically significant improvement in GCSI score after 3 months of G-POEM as compared with pre G-POEM GCSI scores (2.7 (95% C.I. 0–5.5) vs 8.2 (95% C.I. 5.4–11) (p = 0.007). The mean pre G-POEM 4 h GES was 93.8% (95% C.I. 42.3–145.3) with improvement in post G-POEM GES to 44.5% (95% C.I. 0–95)(p = 0.2). The pooled rate of total adverse events was 9% (95% C.I. 2.7–25.9). Our study showed a good clinical success of G-POEM in PsGP patients along with significant improvement in 3-month GCSI scores. There was an improvement of GES after G-POEM, but it did not reach statistical significance. In conclusion, G-POEM is an effective and safe treatment option for PsGP.
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Abbreviations
- CI:
-
Confidence interval
- GCSI:
-
Gastroparesis cardinal symptom index.
- GES:
-
Gastric emptying study
- G-POEM:
-
Gastric per-oral endoscopic pyloromyotomy
- PsGP:
-
Postsurgical gastroparesis
- SD:
-
Standard deviation
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RG and MA did data collection and screening. RG, BPM, and SP did data analysis.
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Garg, R., Mohan, B.P., Aggarwal, M. et al. Peroral Pyloromytomy is Effective and Safe for Postsurgical Gastroparesis. J Gastrointest Surg 24, 1417–1420 (2020). https://doi.org/10.1007/s11605-020-04558-x
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DOI: https://doi.org/10.1007/s11605-020-04558-x