Dataset Information

Evaluation of the safety profile of endoscopic pyloromyotomy by G-POEM: a French multicenter study.

ABSTRACT:

Background

Gastric per oral endoscopic esophageal myotomy (G-POEM) is a promising procedure to treat refractory gastroparesis. The safety profile of G-POEM is an important topic because gastroparesis is a functional pathology, with a procedure whose effectiveness is between 50 and 65% depending on the studies.

Objectives

We present this retrospective multicenter study, with the aim of establishing a safety profile, focusing on serious adverse events (AEs).

Design

This was a multicenter observational cohort study conducted in five French expert centers.

Methods

All patients who underwent G-POEM for refractory gastroparesis between 2015 and 2021 were included for analysis. AEs were classified into per endoscopic, early postoperative, and late postoperative, up to 1 month. Their severity was assessed using Dindo-Clavien and American Society for Gastrointestinal Endoscopy classification. The primary objective was to evaluate the rate of G-POEM severe AEs. Secondary objectives were to document other postoperative AEs, and to identify predictive factors.

Results

In all, 217 patients were included: 81 men and 136 women, mean age 52 ± 17 years. The average procedural time was 44 ± 14 min (12-78). The average hospital stay was 3.7 ± 2.3 days. The AEs rate classified as Clavien-Dindo ⩾3 was 0.4% (one delayed bleeding requiring blood transfusion and endoscopic management). There were no deaths or patients admitted to intensive care unit. The rates of mucosotomy and capnoperitoneum were 3.7 and 1.8%, respectively, without clinical consequences. Most patients (81.5%) did not experience any AE. Three cases of dumping syndrome occurred, quickly managed by dietary measures.

Conclusion

Our study confirms the safety of G-POEM with less than 0.5% of serious AEs, medically managed. This outcome makes this a procedure to have a good benefit-risk ratio.

SUBMITTER: Baret F

PROVIDER: S-EPMC9536103 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Evaluation of the safety profile of endoscopic pyloromyotomy by G-POEM: a French multicenter study.

Baret Florian F Jacques Jeremie J Pioche Mathieu M Albouys Jeremie J Vitton Véronique V Vanbiervliet Geoffroy G Debourdeau Antoine A Barthet Marc M Gonzalez Jean-Michel JM

Therapeutic advances in gastroenterology 20221003

<h4>Background</h4>Gastric per oral endoscopic esophageal myotomy (G-POEM) is a promising procedure to treat refractory gastroparesis. The safety profile of G-POEM is an important topic because gastroparesis is a functional pathology, with a procedure whose effectiveness is between 50 and 65% depending on the studies.<h4>Objectives</h4>We present this retrospective multicenter study, with the aim of establishing a safety profile, focusing on serious adverse events (AEs).<h4>Design</h4>This was a ...[more]

PMID: 36213725

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Project description:BackgroundPostsurgical gastroparesis is recognized as a gastrointestinal dysfunction syndrome following foregut surgery. Gastric peroral endoscopic myotomy (G-POEM) is suggested as a minimally invasive therapy for gastroparesis. But the long-term efficacy and safety of G-POEM in treating postsurgical gastroparesis are rarely explored.MethodsThe primary outcomes included the symptomatic improvement based on gastroparesis cardinal symptoms index (GCSI) and the improvement of gastric emptying. The secondary outcomes included the improvement of gastroesophageal reflux symptoms and complications of G-POEM.ResultsThe severity of postsurgical gastroparesis was not associated with the onset time and the course of the disease. G-POEM significantly reduced GCSI throughout the follow-up period (p < 0.0001). For different anastomotic site, a significant improvement of GCSI was found at 6 month post-G-POEM (F4,165 = 74.18, p < 0.0001). Subscale analysis of GCSI showed that nausea/vomiting, post-prandial fullness/early satiety, and bloating were improved significantly at 6-month post-G-POEM (p < 0.0001, respectively). Half-emptying and whole-emptying time were significantly shortened in patients with different anastomotic site post-G-POEM (half-emptying time: F3,174 = 65.44, p < 0.0001; whole-emptying time: F3,174 = 54.85, p < 0.0001). The emptying of ioversol was obviously accelerated after G-POEM. GCSI wasn't related to pyloric length, pyloric diameter, and thickness of pyloric wall. GERDQ was also used to evaluate the clinical efficacy of G-POEM. For each time points, GERDQ didn't differ significantly in patients with different anastomotic site (F4,104 = 0.8075, p = 0.5231). For patients with different anastomotic site, GERDQ was improved significantly at different time points (F4,104 = 59.11, p < 0.0001). The higher the esophageal anastomotic site was, the faster G-POEM improved the symptoms of gastroesophageal reflux. No one required re-hospitalization for any complication.ConclusionG-POEM is a minimally invasive therapy with long-term effectiveness and safety in treating postsurgical gastroparesis.

Dataset Information

Evaluation of the safety profile of endoscopic pyloromyotomy by G-POEM: a French multicenter study.

Background

Objectives

Design

Methods

Results

Conclusion

Publications

Evaluation of the safety profile of endoscopic pyloromyotomy by G-POEM: a French multicenter study.

Similar Datasets

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