Background: Gastroparesis is a chronic gastric motility disorder. Management of affected patients is challenging and efficacy of medical treatment often disappointing. Gastric Per- Oral Endoscopic Myotomy (GPOEM) with antro-pyloromyotomy represents a promising alternative technique in the treatment of these patients. The aim of this study was to evaluate the efficacy and safety of GPEOM in a tertiary center and identify possible factors predicting patient outcome.
Method: This was a retrospective single center study, analyzing data of patients with gastroparesis treated by GPOEM. The primary objective was to evaluate the clinical and technical success of GPOEM during a 12-month follow-up. The evolution of clinical response was evaluated using GCSI score and VAS at 1,3,6 and 12 months post GPOEM. The secondary objective was to investigate some potentially predictive factors for clinical response.
Results: Between January 2019 and August 2021, 37 patients were included. 70.3% (n=26/37) patients had clinical success. After 12 months of follow-up, 68.7% (n=11/16) of patients showed sustained clinical response. The median pre-procedural GCSI score was 2.8 (range: 2.6-3.4, n=37) with a significant improvement after 12-month with a median GCSI of 0.5 (range: 0.0-1.7, n=16; p<0.001). Three mild intra-procedural complications occurred. The analysis of potentially predictive factors, such as diabetes, previous medical treatment, prior pyloric botulinum toxin injection, and symptom onset, showed no statistically significant differences with regard to the clinical success rate.
Conclusion: GPOEM is an endoscopic treatment of gastroparesis with an acceptable efficacy in the short and long term. The technical success and the safety profile are excellent. Statistically significant predictive factors of patient outcome could not be identified and further studies of larger size are needed.