Per oral endoscopic pyloromyotomy for refractory gastroparesis: initial results from a single institution

Rodriguez, John; Haskins, Ivy N.; Strong, Andrew T.; Plescia, Ryan L.; Allemang, Matthew T.; Butler, Robert S.; Cline, Michael; El‐Hayek, Kevin; Ponsky, Jeffrey L.; Kroh, Matthew

doi:10.1007/s00464-017-5619-5

Cited by 100 publications

(106 citation statements)

References 21 publications

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“…Initially a submucosal bleb is raised with an injection of a solution containing methylene blue approximately 4 cm proximal to the pylorus along the lesser curvature of the stomach. 36 Some authors have reported a greater curve approach but we find that this induces more retroflexion of the endoscope. Our group prefers to use a triangle tip knife for the initial mucosotomy, submucosal dissection, and muscular division of the pylorus.…”

Section: Surgical Techniquementioning

confidence: 49%

“…Initially described in 2013, the procedures is increasing in popularity and data reported in the literature. 34…”

Section: Discussionmentioning

confidence: 99%

“…Several therapies are available for patients with gastroparesis and may be selected based etiology and chronicity of disease. 34 Such interventions include but are not limited to gastric decompression, pyloroplasty, gastric electrical stimulation, and gastrectomy, in addition to endoscopic therapies for palliation. The most analogous endoscopic therapy is POP which is designed to disrupt the pyloric ring and allow for improved gastric emptying.…”

Section: Patient Selection and Preoperative Assessmentmentioning

confidence: 99%

“…A full 4-hour nonextrapolated gastric emptying study off of narcotics confirms the diagnosis in the appropriate clinical setting. 36…”

Section: Patient Selection and Preoperative Assessmentmentioning

confidence: 99%

“…Anteriorly, the pylorus is divided and the myotomy is extended 1 to 2 cm back onto the stomach. 36 After hemostasis is assured, the mucosotomy is closed with a series of endoscopic clips. Postoperatively, a fluoroscopic exam may be used to evaluate for obstruction or leakage.…”

Section: Surgical Techniquementioning

confidence: 99%

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Endoscopic Intramural Surgery Part II: Muscular Division

Barajas‐Gamboa¹,

Corcelles²,

Kroh³

2018

Dig Dis Interv

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The development of endoscopic technologies and the introduction of new surgical concepts during the last decade has led to an evolution of surgical treatment of gastrointestinal disorders including achalasia, gastroesophageal reflux, gastroparesis, inflammatory bowel disease, and tumors of the gastrointestinal tract. Intramural surgery creates a novel approach to perform muscular division, submucosal dissection, and tumor removal. These procedures have proven safe and effective, and increasingly are part of the surgical endoscopist's toolbox. Intramural surgical procedures include peroral esophagomyotomy (POEM), peroral pyloromyotomy (POP), Zenker's diverticulotomy, and submucosal tunneling and endoscopic resection (STER) of lesions. The objective of this article is to describe current intramural surgery procedures that comprise muscular division, as well as clinical outcomes and its impact on surgical endoscopic practices.

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Section: Surgical Techniquementioning

confidence: 49%

“…Initially described in 2013, the procedures is increasing in popularity and data reported in the literature. 34…”

Section: Discussionmentioning

confidence: 99%

Section: Patient Selection and Preoperative Assessmentmentioning

confidence: 99%

“…A full 4-hour nonextrapolated gastric emptying study off of narcotics confirms the diagnosis in the appropriate clinical setting. 36…”

Section: Patient Selection and Preoperative Assessmentmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

See 3 more Smart Citations

Endoscopic Intramural Surgery Part II: Muscular Division

Barajas‐Gamboa¹,

Corcelles²,

Kroh³

2018

Dig Dis Interv

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Gastroparesis in the Hospital Setting

Rangan

Ukleja

2020

Nut in Clin Prac

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Gastroparesis (GP) is commonly seen in hospitalized patients. Refractory vomiting and related dehydration, electrolyte abnormalities, and malnutrition are indications for hospital admission. In addition, tube feeding intolerance is a common sign of gastric dysmotility in critically ill patients. The diagnosis and management of GP in the hospital setting can be quite challenging. Diagnostic tests are often deferred because of patient intolerance of the oral meal for standard scintigraphy or severity of the primary disease. The diagnosis of GP is often established on the basis of clinical scenario and risk factors for gastric motor dysfunction. Medical therapy in GP is directed toward controlling nausea and vomiting by prokinetic and antinausea medications and correcting nutrition risks or treating malnutrition with nutrition therapy. Enteral nutrition is the preferred nutrition intervention for patients with GP. Delayed gastric emptying in critically ill patients has a negative impact on the timely delivery of enteral feeding and meeting the energy and protein goals. Measures to improve gastric tolerance or provide feeding beyond the stomach are often needed, since early enteral nutrition has been an important target of therapy for critically ill patients. This review will address the current understanding of the mechanisms of GP and feeding intolerance in critical illness, diagnostic workup, drug therapies, and interventions to improve the provision of enteral nutrition in hospital settings when gastric dysmotility is present or suspected.

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Endoscopic Pyloromyotomy (G-POEM): Indications, Techniques, and Outcomes

Maydeo¹

2021

Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy

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Per oral endoscopic pyloromyotomy for refractory gastroparesis: initial results from a single institution

Abstract: POP is a safe and feasible endoscopic intervention for medical refractory gastroparesis. Additional follow-up is required to determine the long-term success of this approach in alleviating gastroparesis symptoms.

Cited by 100 publications

References 21 publications

Endoscopic Intramural Surgery Part II: Muscular Division

Endoscopic Intramural Surgery Part II: Muscular Division

Gastroparesis in the Hospital Setting

Endoscopic Pyloromyotomy (G-POEM): Indications, Techniques, and Outcomes

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