Gastric Peroral Endoscopic Pyloromyotomy Reduces Symptoms, Increases Quality of Life, and Reduces Health Care Use For Patients With Gastroparesis

Mekaroonkamol, Parit; Dacha, Sunil; Wang, Lei; Li, Xiaoyü; Jiang, Yueping; Li, Lianyong; Tian, Lu; Shahnavaz, Nikrad; Sakaria, Sonali; LeVert, F. E.; Keilin, Steven; Willingham, Field F.; Christie, Jennifer; Cai, Qiang

doi:10.1016/j.cgh.2018.04.016

Cited by 72 publications

(110 citation statements)

References 30 publications

(54 reference statements)

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“…Most of the reported studies originate from tertiary-care centres with endoscopic expertise and demonstrate 100% technical success. A recent study showed decline in ER visits and hospitalisation following G-POEM 155. The available data allow assessment of short-term efficacy.…”

Section: Introductionmentioning

confidence: 99%

Gastroparesis: a turning point in understanding and treatment

Grover

Farrugia

Stanghellini

2019

Gut

180

219

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Gastroparesis is defined by delayed gastric emptying (GE) and symptoms of nausea, vomiting, bloating, postprandial fullness, early satiety and abdominal pain. Most common aetiologies include diabetes, postsurgical and postinfectious, but in many cases it is idiopathic. Clinical presentation and natural history vary by the aetiology. There is significant morbidity and healthcare utilisation associated with gastroparesis. Mechanistic studies from diabetic animal models of delayed GE as well as human full-thickness biopsies have significantly advanced our understanding of this disorder. An innate immune dysregulation and injury to the interstitial cells of Cajal and other components of the enteric nervous system through paracrine and oxidative stress mediators is likely central to the pathogenesis of gastroparesis. Scintigraphy and 13C breath testing provide the most validated assessment of GE. The stagnant gastroparesis therapeutic landscape is likely to soon see significant changes. Relatively newer treatment strategies include antiemetics (aprepitant), prokinetics (prucalopride, relamorelin) and fundic relaxants (acotiamide, buspirone). Endoscopic pyloromyotomy appears promising over the short term, especially for symptoms of nausea and vomiting. Further controlled trials and identification of the appropriate subgroup with pyloric dysfunction and assessment of long-term outcomes are essential. This review highlights the clinical presentation, diagnosis, mechanisms and treatment advancements for gastroparesis.

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Section: Introductionmentioning

confidence: 99%

Gastroparesis: a turning point in understanding and treatment

Grover

Farrugia

Stanghellini

2019

Gut

180

219

View full text Add to dashboard Cite

show abstract

“…). The technical success reached 100% coupled with significant symptomatic improvement as assessed by GCSI ( P < 0.0005), statistically significant reduction in hospitalization related to gastroparesis ( P = 0.0002), and improved quality of life ( P < 0.0005) . Moreover, Kahaleh et al .…”

Section: Evidence Through Literaturementioning

confidence: 96%

“…reported 13 patients who underwent G‐POEM for refractory gastroparesis (one diabetic, four idiopathic, and eight postsurgical) with clinical and GES improvement occurring in 73% and 67% respectively and GES normalization in 33% of patients . Mekaroonkamol et al . reported 30 patients with refractory gastroparesis who underwent G‐POEM (some patients reported by Mekaroonkamol et al .…”

Section: Evidence Through Literaturementioning

confidence: 99%

State of the art review with literature summary on gastric peroral endoscopic pyloromyotomy for gastroparesis

Khoury

Mizrahi

Mahamid

et al. 2018

J of Gastro and Hepatol

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Gastroparesis is a debilitating progressive disease that significantly impacts a patient's life with limited and challenging treatments available. Although the pathogenesis is multifactorial, pylorospasm is believed to have a major underlying role. Several therapeutic interventions directed to the pylorus have been developed over the last decade, including intra-pyloric injections of botulinum toxin, transpyloric stenting, and surgical pyloroplasty. All of these treatment options had limited and disappointing results. More recently, gastric peroral endoscopic myotomy (G-POEM) has been reported as a treatment for refractory gastroparesis. In this review article, we provide an overview on gastroparesis with a focus on the therapeutic interventions. In addition, we provide a literature summary and pool analysis of the clinical efficacy, scintigraphic efficacy, and safety profile of all studies that evaluated G-POEM in gastroparesis. Overall, seven studies have reported on the use of G-POEM in gastroparesis, and the pooled analysis of these studies showed a technical success of 100%, with clinical efficacy as assessed by the Gastroparesis Cardinal Symptoms Index of 81.5%, gastric emptying scintigraphy normalization in approximately 55.5% of the cases, perioperative complications in 7.6%, and intraoperative complications in 6.6%. This suggests that G-POEM is a new promising therapeutic intervention for the treatment of gastroparesis with durable effect and limited potential adverse events.

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“…Gastric POEM first described by Khashab et al 28 in 2013 is fast becoming a treatment option for refractory gastroparesis especially for symptoms of nausea and vomiting. 29 Mekaroonkamol et al 29 compared refractory gastroparesis patients who underwent gastric POEM and those without, and they found the procedure significantly improved symptoms and quality of life, as well as reduced health care use related to gastroparesis.…”

Section: Future Of Gastroparesis In Asiamentioning

confidence: 99%

Knowledge, Attitude, and Practice Survey of Gastroparesis in Asia by Asian Neurogastroenterology and Motility Association

Oshima

Siah

Kim

et al. 2021

J Neurogastroenterol Motil

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Gastric Peroral Endoscopic Pyloromyotomy Reduces Symptoms, Increases Quality of Life, and Reduces Health Care Use For Patients With Gastroparesis

Abstract: In a retrospective study of patients who underwent GPOEM for refractory gastroparesis, we found the procedure significantly improved symptoms, increased quality of life, and reduced health care use related to gastroparesis.

Cited by 72 publications

References 30 publications

Gastroparesis: a turning point in understanding and treatment

Gastroparesis: a turning point in understanding and treatment

State of the art review with literature summary on gastric peroral endoscopic pyloromyotomy for gastroparesis

Knowledge, Attitude, and Practice Survey of Gastroparesis in Asia by Asian Neurogastroenterology and Motility Association

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