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Gastric peroral endoscopic pyloromyotomy for refractory gastroparesis: a systematic review of early outcomes with pooled analysis.
Gastrointestinal Endoscopy ( IF 7.7 ) Pub Date : 2019-12-03 , DOI: 10.1016/j.gie.2019.11.039 Marco Spadaccini 1 , Roberta Maselli 1 , Viveksandeep Thoguluva Chandrasekar 2 , Andrea Anderloni 1 , Silvia Carrara 1 , Piera Alessia Galtieri 1 , Milena Di Leo 1 , Alessandro Fugazza 1 , Gaia Pellegatta 1 , Matteo Colombo 1 , Rossella Palma 1 , Cesare Hassan 3 , Amrita Sethi 4 , Mouen A Khashab 5 , Prateek Sharma 2 , Alessandro Repici 1
Gastrointestinal Endoscopy ( IF 7.7 ) Pub Date : 2019-12-03 , DOI: 10.1016/j.gie.2019.11.039 Marco Spadaccini 1 , Roberta Maselli 1 , Viveksandeep Thoguluva Chandrasekar 2 , Andrea Anderloni 1 , Silvia Carrara 1 , Piera Alessia Galtieri 1 , Milena Di Leo 1 , Alessandro Fugazza 1 , Gaia Pellegatta 1 , Matteo Colombo 1 , Rossella Palma 1 , Cesare Hassan 3 , Amrita Sethi 4 , Mouen A Khashab 5 , Prateek Sharma 2 , Alessandro Repici 1
Affiliation
BACKGROUND AND AIMS
Gastroparesis (GP) is a chronic debilitating condition. Prior pyloric-targeted procedures are either invasive or have questionable efficacy. Gastric peroral pyloromyotomy (G-POEM) has been proposed as a minimally invasive approach. We performed a pooled analysis to evaluate the efficacy and safety of G-POEM for GP.
METHODS
Electronic databases (Medline, Scopus, EMBASE) were searched up to January 2019. Studies including patients who underwent G-POEM for GP were eligible. Procedural, clinical, and safety outcomes were assessed by pooling data with a random- or fixed-effect model according to the degree of heterogeneity to obtain a proportion with a 95% confidence interval.
RESULTS
Ten studies were eligible for inclusion (292 patients), and 2 of the 10 studies were prospective. Seven studies were performed in the United States, 2 in France, and 1 in China. Endoscopic pyloromyotomy was feasible in all patients. Significant symptomatic improvement was achieved after 83.9% of procedures (mean follow-up, 7.8 ± 5.5 months). When comparing the mean values of pre- and postprocedural scintigraphic evolution, there was a significant decrease of the residual percentage at 2 and 4 hours. The overall adverse events rate was 6.8%.
CONCLUSIONS
G-POEM appears to be a promising approach for GP in terms of safety and efficacy outcomes in the short term.
更新日期：2019-12-04
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