GASTRIC PERORAL ENDOSCOPIC MYOTOMY (G-POEM) FOR REFRACTORY GASTROPARESIS: 12-MONTH FOLLOW-UP RESULTS FROM AN ITALIAN TERTIARY ACADEMIC HOSPITAL

Aims The aim of this prospective observational study is to evaluate the efficacy of the G-POEM in 12 months-follow up in patients with gastroparesis refractory to medical therapy. Methods Eighteen patients with refractory gastroparesis, who consecutively underwent G-POEM from March 2019 to October 2020 at San Raffaele Hospital (Milan, Italy), were enrolled. Primary outcome was clinical success, defined as an improvement≥50% in the average Gastroparesis Cardinal Symptom Index (GCSI) score at 12 months, compared to baseline. Secondary outcomes were technical success, changes at gastric emptying study (GES) at 3 months, and to identify any predictive factors of clinical success. Results Clinical success was 38.89% at 3 months, 62.5% at 6 months and 71.4% after 1 year. Average GCSI score reduced significantly: 2,64±0,92 at baseline, 1,42±0,78 at 3 months (p<0.0001), 1,14±0,82 at 6 months (p<0.0001) and 1,19±0,78 at one year (p<0.0001) after G-POEM. Technical success was achieved in all procedures (100%). One intraprocedural pneumomediastinum, 2 mucosal burns and 1 perforation were observed. At 3 months-GES, gastric emptying half time and percent 2-hours gastric retention reduced modestly (p=0.22 and p=0.12). Univariate regression analysis showed post-surgical gastroparesis (p=0.05), baseline nausea/vomiting GCSI score (p=0.03) and baseline fullness/early satiety GCSI score (p=0.02) had significant association with clinical success at 12 months. Conclusions G-POEM may be an effective procedure for patients with refractory gastroparesis, although the correlation between symptoms and gastric motility remains to be understood. Publication History Article published online: 14 April 2022 © 2022. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany