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

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.