Endoscopy 2019; 51(04): S115
DOI: 10.1055/s-0039-1681508
ESGE Days 2019 oral presentations
Saturday, April 6, 2019 11:00 – 13:00: Best abstract awards Congress Hall
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC PYLOROMYOTOMY (G-POEM), EFFICACITY EVALUATION AFTER ONE YEAR, IN REFRACTORY GASTROPARESIS: A FRENCH MULTICENTRIC STUDY

O Ragi
1   Hôpital Dupuytren, Limoges, France
,
J Jacques
1   Hôpital Dupuytren, Limoges, France
,
J Branche
2   Hôpital Claude Huriez, Lille, France
,
S Leblanc
3   Hôpital Cochin, Paris, France
,
G Vanbiervliet
4   Hôpital de l'Archet 2, Nice, France
,
R Legros
1   Hôpital Dupuytren, Limoges, France
,
M Pioche
5   Hôpital Edouard Herriot, Lyon, France
,
J Rivory
5   Hôpital Edouard Herriot, Lyon, France
,
S Chaussade
3   Hôpital Cochin, Paris, France
,
V Vitton
6   Hôpital Nord, Marseille, France
,
M Barthet
6   Hôpital Nord, Marseille, France
,
JM Gonzalez
6   Hôpital Nord, Marseille, France
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

 

Aims:

Long term results of G-POEM for refractory gastroparesis are lacking. Here we report the results of the largest multicenter study with long term follow up about G-POEM for refractory gastroparesis.

Methods:

Retrospective, multicentric study of all G-POEM cases, performed in six French expert centers, for refractory gastroparesis, within at least one year of follow up.

Primary Endpoint: One year clinical success defined by improvement of GCSI by at least one point.

Secondary Endpoints: complications rate, identification of predictors of clinical success, clinical success at two years.

Results:

Description of the population: 93 patients were included in 6 French expert centers. 65% were women, the medium age was 52 years old. About aetiologies: 31% diabetes, 25% post-surgery, 34% idiopathic and 8,5% systemic disease. The medium evolution duration of the symptoms was 73,5 months. The mean 4h% remaining in stomach before G-POEM, was 44,6%. The mean GCSI average before G-POEM was 3,6.

Technical success was achieved in 96,1%.

Primary Endpoint: Clinical success was achieved in 71% at 6 month, and 69% at one year, with an average decreasing GCSI score of 1,6 point.

Secondary Endpoints: In multivariate analysis, only an high fullness underscore was significatively associated with an efficacity of the G-POEM (OR = 2,3 (1,35 – 3,88) p = 0,002). 18,3% of the patients declared pain after the therapeutic, controlled by paracetamol and PPI. 4,1% of the patients had complications, with a positive evolution under medical treatment. At two years clinical success was 69% (n = 39).

Conclusions:

This study confirms the efficiency and safety of G-POEM in the treatment of refractory gastroparesis The clinical success after one year is achieved for 69% of the patients. Only a high fullness subscale of the GCSI predicts efficiency. G-POEM should be the first treatment in case of refractory gastroparesis.