Endoscopy 2020; 52(S 01): S34
DOI: 10.1055/s-0040-1704109
ESGE Days 2020 oral presentations
Saturday, April 25, 2020 11:00 – 13:00 Advances in endoluminal endoscopy Liffey Meeting Room 2
© Georg Thieme Verlag KG Stuttgart · New York

GASTRIC PERORAL ENDOSCOPIC PYLOROMYOTOMY FOR THE TREATMENT OF REFRACTORY GASTROPARESIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

C Zhong
1   Affliated Hospital of Southwest Medical University, Department of Gastroenterology, Luzhou, China
,
S Tan
1   Affliated Hospital of Southwest Medical University, Department of Gastroenterology, Luzhou, China
,
Y Peng
1   Affliated Hospital of Southwest Medical University, Department of Gastroenterology, Luzhou, China
,
X Tang
1   Affliated Hospital of Southwest Medical University, Department of Gastroenterology, Luzhou, China
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

 

Aims Gastric peroral endoscopic pyloromyotomy (G-POEM) is a novel minimally invasive intervention for treating refractory gastroparesis. We conducted a systematic review and meta-analysis to determine the clinical success and safety of G-POEM.

Methods The systematic review was conducted following the PRISMA guidelines. Pubmed, EMBASE, Cochrane, were searched during January 2013 to February 2019. The literature was selected independently by two reviewers according to the inclusion and exclusion criteria. The statistical analysis was carried out using Comprehensive Meta-Analysis software version 2.

Results A total of 8 studies involving 259 patients were included in the final analysis. The major cause for gastroparesis were idiopathic (n=106, 40.93%), postsurgical (n=72, 27.80%), diabetes-associated (n=68, 26.25%), and other causes (n=13, 5.02%). After G-POEM, mean Gastroparesis Cardinal Symptom Index (GCSI) score was significantly decreased by 1.21 points (95%CI, 0.63-1.78, P< .001, I2=80%) and 4-hour retention on gastric emptying scintigraphy (GES) was significantly reduced by 24.77% (95% CI, 15.60%-33.94%, P< .001, I2=61%). The pooled rate of normal GES at 4 hours were 50.5% (95% CI, 41.0%-60.0%) and the pooled complication rate of G-POEM which was occurred in 35 patients (14.2%; 95% CI, 5.7%-31.3%). The most frequently reported complications were pain, mucosal perforation, difficulty swallowing and nosocomial pneumonia. None of these studies reported severe and fatal complication related to G-POEM.

Conclusions G-POEM is an effective and safe technique for refractory gastroparesis. Further randomized comparative studies of G-POEM and other therapeutic methods are warranted to determine the most effective treatment modality for refractory gastroparesis.