P Mekaroonkamol1, L Y Li2, S Dacha1, Y Xu3, S D Keilin1, F F Willingham1, Q Cai1. 1. Division of Digestive Diseases, Emory University, Atlanta, GA, USA. 2. Division of Digestive Diseases, PLA 306 Hospital, Beijing, China. 3. Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou, China.
Abstract
BACKGROUND: Gastroparesis is a poorly understood, chronic, debilitating motility disorder with very limited medical therapeutic options. Gastric peroral endoscopic pyloromyotomy (G-POEM) is an emerging novel endoscopic technique as an incisionless pyloroplasty for refractory cases. Effective information of G-POEM on different types of gastroparesis is sparse. METHODS: Cases of G-POEM using selective circular myotomy as a salvage therapy for refractory symptoms were retrospective studied. The G-POEM procedures were performed by a single expert endoscopist under a certain protocol. Gastroparesis Cardinal Symptoms Index (GCSI) and gastric emptying scintigraphy (GES) were evaluated before and after the procedure. Procedures related adverse event were also recorded. KEY RESULTS: All procedures were successfully completed without complications. Each case in this series was different in demography and etiology of gastroparesis, namely postsurgical, postinfectious, and idiopathic gastroparesis in an elderly male and two young female adults. All cases were refractory to conventional treatment but demonstrated obvious success after G-POEM as a salvage therapy both clinically and on GES. CONCLUSIONS & INFERENCES: G-POEM as a salvage therapy improves symptoms and gastric emptying in patients with different types of refractory gastroparesis. Our cases are also the firsts to show success of G-POEM in postinfectious gastroparesis and in elderly male patient. More data are needed to determine which subgroup of patients would benefit most from this novel procedure.
BACKGROUND:Gastroparesis is a poorly understood, chronic, debilitating motility disorder with very limited medical therapeutic options. Gastric peroral endoscopic pyloromyotomy (G-POEM) is an emerging novel endoscopic technique as an incisionless pyloroplasty for refractory cases. Effective information of G-POEM on different types of gastroparesis is sparse. METHODS: Cases of G-POEM using selective circular myotomy as a salvage therapy for refractory symptoms were retrospective studied. The G-POEM procedures were performed by a single expert endoscopist under a certain protocol. Gastroparesis Cardinal Symptoms Index (GCSI) and gastric emptying scintigraphy (GES) were evaluated before and after the procedure. Procedures related adverse event were also recorded. KEY RESULTS: All procedures were successfully completed without complications. Each case in this series was different in demography and etiology of gastroparesis, namely postsurgical, postinfectious, and idiopathic gastroparesis in an elderly male and two young female adults. All cases were refractory to conventional treatment but demonstrated obvious success after G-POEM as a salvage therapy both clinically and on GES. CONCLUSIONS & INFERENCES: G-POEM as a salvage therapy improves symptoms and gastric emptying in patients with different types of refractory gastroparesis. Our cases are also the firsts to show success of G-POEM in postinfectious gastroparesis and in elderly male patient. More data are needed to determine which subgroup of patients would benefit most from this novel procedure.
Authors: H B Xue; H Z Fan; X M Meng; S Cristofaro; P Mekaroonkamol; S Dacha; L Y Li; X L Fu; S H Zhan; Q Cai Journal: Surg Endosc Date: 2017-04-13 Impact factor: 4.584
Authors: Aung S Myint; Brandon Rieders; Mohammed Tashkandi; Marie L Borum; Joyce M Koh; Sindu Stephen; David B Doman Journal: Gastroenterol Hepatol (N Y) Date: 2018-11
Authors: Matthew T Allemang; Andrew T Strong; Ivy N Haskins; John Rodriguez; Jeffrey L Ponsky; Matthew Kroh Journal: J Gastrointest Surg Date: 2017-07-27 Impact factor: 3.452