Laparoscopic pyloroplasty versus endoscopic per-oral pyloromyotomy for the treatment of gastroparesis
Background Gastroparesis is a debilitating functional disorder of the stomach characterized by delayed gastric emptying absent an obstructive etiology. Surgical or endoscopic disruption of the pylorus has been utilized to treat this disease, but there is little evidence comparing laparoscopic pyloro...
Gespeichert in:
| Veröffentlicht in: | Surgical endoscopy 2019-03, Vol.33 (3), p.773-781 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 781 |
|---|---|
| container_issue | 3 |
| container_start_page | 773 |
| container_title | Surgical endoscopy |
| container_volume | 33 |
| creator | Landreneau, Joshua P. Strong, Andrew T. El-Hayek, Kevin Tu, Chao Villamere, James Ponsky, Jeffrey L. Kroh, Matthew D. Rodriguez, John H. |
| description | Background
Gastroparesis is a debilitating functional disorder of the stomach characterized by delayed gastric emptying absent an obstructive etiology. Surgical or endoscopic disruption of the pylorus has been utilized to treat this disease, but there is little evidence comparing laparoscopic pyloroplasty (LP) with endoscopic per-oral pyloromyotomy (POP). Herein we describe our experience at our institution using a propensity-matched cohort study to compare outcomes between these procedures.
Methods
All patients who underwent LP for the treatment of gastroparesis from October 2014 through September 2017 at our institution were retrospectively reviewed. Propensity scoring was used to match these patients 1:1 to patients undergoing POP during this time period based on gender, age, and etiology of gastroparesis. Symptom scores using the Gastroparesis Cardinal Symptom Index (GCSI), scintigraphic gastric emptying studies (GES), and perioperative outcomes were compared between matched cohorts. Thirty patients underwent LP for gastroparesis during the study period which were matched 1:1 with patients undergoing POP. The etiology of gastroparesis was 63.3% idiopathic (
n
= 19), 20.0% post-surgical (
n
= 6), and 16.7% diabetic (
n
= 5) in both cohorts.
Results
Patients who underwent LP had a longer average length of stay (4.6 vs. 1.4 days,
p
= 0.003), operative time (99.3 vs. 33.9 min,
p
|
| doi_str_mv | 10.1007/s00464-018-6342-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2071583040</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2071583040</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-6df2854ef13b0b323910024fb62f2bfb81cb908d1742ee1c7932e8c8f232818a3</originalsourceid><addsrcrecordid>eNp1kT1PwzAQhi0EoqXwA1hQJBYWw_nsJs6IEF9SJRaYIyc9l1ZJHOwEqf8el5YiIbGch3v8-HwvY-cCrgVAdhMAVKo4CM1TqZCnB2wslESOKPQhG0MugWOWqxE7CWEFEc_F9JiNJIDIEWHMaGY6412oXLeskm5dO--62oR-nXySD0NIqJ3v2-S586becc3a9bEk1vmkf6ek92T6hto-cTZZREdUGU9hGU7ZkTV1oLPdOWFvD_evd0989vL4fHc745XMsOfp3KKeKrJCllBKlHn8JipbpmixtKUWVZmDnotMIZGoslwi6UpblKiFNnLCrrbezruPgUJfNMtQUV2bltwQCoRMTLUEBRG9_IOu3ODbON03BQhaTCMltlQVdxQ82aLzy8b4dSGg2GRQbDMoYgbFJoNYJuxiZx7Khub7Gz9LjwBugRBb7YL879P_W78A1GGSzg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2071020815</pqid></control><display><type>article</type><title>Laparoscopic pyloroplasty versus endoscopic per-oral pyloromyotomy for the treatment of gastroparesis</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Landreneau, Joshua P. ; Strong, Andrew T. ; El-Hayek, Kevin ; Tu, Chao ; Villamere, James ; Ponsky, Jeffrey L. ; Kroh, Matthew D. ; Rodriguez, John H.</creator><creatorcontrib>Landreneau, Joshua P. ; Strong, Andrew T. ; El-Hayek, Kevin ; Tu, Chao ; Villamere, James ; Ponsky, Jeffrey L. ; Kroh, Matthew D. ; Rodriguez, John H.</creatorcontrib><description>Background
Gastroparesis is a debilitating functional disorder of the stomach characterized by delayed gastric emptying absent an obstructive etiology. Surgical or endoscopic disruption of the pylorus has been utilized to treat this disease, but there is little evidence comparing laparoscopic pyloroplasty (LP) with endoscopic per-oral pyloromyotomy (POP). Herein we describe our experience at our institution using a propensity-matched cohort study to compare outcomes between these procedures.
Methods
All patients who underwent LP for the treatment of gastroparesis from October 2014 through September 2017 at our institution were retrospectively reviewed. Propensity scoring was used to match these patients 1:1 to patients undergoing POP during this time period based on gender, age, and etiology of gastroparesis. Symptom scores using the Gastroparesis Cardinal Symptom Index (GCSI), scintigraphic gastric emptying studies (GES), and perioperative outcomes were compared between matched cohorts. Thirty patients underwent LP for gastroparesis during the study period which were matched 1:1 with patients undergoing POP. The etiology of gastroparesis was 63.3% idiopathic (
n
= 19), 20.0% post-surgical (
n
= 6), and 16.7% diabetic (
n
= 5) in both cohorts.
Results
Patients who underwent LP had a longer average length of stay (4.6 vs. 1.4 days,
p
= 0.003), operative time (99.3 vs. 33.9 min,
p
< 0.001), and estimated blood loss (12.9 vs. 0.4 mL,
p
< 0.001). There were more complications in the LP cohort (16.7 vs. 3.3%,
p
= 0.086), which included surgical site infection (6.7 vs. 0%,
p
= 0.153), pneumonia (6.7 vs. 0.0%,
p
= 0.153), and unplanned ICU admission (10.0 vs. 0.0%,
p
= 0.078). LP and POP both resulted in similar, significant improvements in both in GCSI scores and objective gastric emptying.
Conclusions
Per-oral endoscopic pyloromyotomy (POP) is safe and effective for the treatment of medical refractory gastroparesis. POP has less perioperative morbidity compared to LP with
comparative functional outcomes
.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-018-6342-6</identifier><identifier>PMID: 30019220</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Endoscopy ; Etiology ; Female ; Follow-Up Studies ; Gastroenterology ; Gastroparesis - surgery ; Gynecology ; Hepatology ; Humans ; Laparoscopy ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Natural Orifice Endoscopic Surgery ; Proctology ; Pyloromyotomy - methods ; Pylorus - diagnostic imaging ; Pylorus - surgery ; Retrospective Studies ; Surgery ; Treatment Outcome</subject><ispartof>Surgical endoscopy, 2019-03, Vol.33 (3), p.773-781</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>Surgical Endoscopy is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-6df2854ef13b0b323910024fb62f2bfb81cb908d1742ee1c7932e8c8f232818a3</citedby><cites>FETCH-LOGICAL-c372t-6df2854ef13b0b323910024fb62f2bfb81cb908d1742ee1c7932e8c8f232818a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-018-6342-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-018-6342-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30019220$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Landreneau, Joshua P.</creatorcontrib><creatorcontrib>Strong, Andrew T.</creatorcontrib><creatorcontrib>El-Hayek, Kevin</creatorcontrib><creatorcontrib>Tu, Chao</creatorcontrib><creatorcontrib>Villamere, James</creatorcontrib><creatorcontrib>Ponsky, Jeffrey L.</creatorcontrib><creatorcontrib>Kroh, Matthew D.</creatorcontrib><creatorcontrib>Rodriguez, John H.</creatorcontrib><title>Laparoscopic pyloroplasty versus endoscopic per-oral pyloromyotomy for the treatment of gastroparesis</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Gastroparesis is a debilitating functional disorder of the stomach characterized by delayed gastric emptying absent an obstructive etiology. Surgical or endoscopic disruption of the pylorus has been utilized to treat this disease, but there is little evidence comparing laparoscopic pyloroplasty (LP) with endoscopic per-oral pyloromyotomy (POP). Herein we describe our experience at our institution using a propensity-matched cohort study to compare outcomes between these procedures.
Methods
All patients who underwent LP for the treatment of gastroparesis from October 2014 through September 2017 at our institution were retrospectively reviewed. Propensity scoring was used to match these patients 1:1 to patients undergoing POP during this time period based on gender, age, and etiology of gastroparesis. Symptom scores using the Gastroparesis Cardinal Symptom Index (GCSI), scintigraphic gastric emptying studies (GES), and perioperative outcomes were compared between matched cohorts. Thirty patients underwent LP for gastroparesis during the study period which were matched 1:1 with patients undergoing POP. The etiology of gastroparesis was 63.3% idiopathic (
n
= 19), 20.0% post-surgical (
n
= 6), and 16.7% diabetic (
n
= 5) in both cohorts.
Results
Patients who underwent LP had a longer average length of stay (4.6 vs. 1.4 days,
p
= 0.003), operative time (99.3 vs. 33.9 min,
p
< 0.001), and estimated blood loss (12.9 vs. 0.4 mL,
p
< 0.001). There were more complications in the LP cohort (16.7 vs. 3.3%,
p
= 0.086), which included surgical site infection (6.7 vs. 0%,
p
= 0.153), pneumonia (6.7 vs. 0.0%,
p
= 0.153), and unplanned ICU admission (10.0 vs. 0.0%,
p
= 0.078). LP and POP both resulted in similar, significant improvements in both in GCSI scores and objective gastric emptying.
Conclusions
Per-oral endoscopic pyloromyotomy (POP) is safe and effective for the treatment of medical refractory gastroparesis. POP has less perioperative morbidity compared to LP with
comparative functional outcomes
.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Endoscopy</subject><subject>Etiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology</subject><subject>Gastroparesis - surgery</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Natural Orifice Endoscopic Surgery</subject><subject>Proctology</subject><subject>Pyloromyotomy - methods</subject><subject>Pylorus - diagnostic imaging</subject><subject>Pylorus - surgery</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kT1PwzAQhi0EoqXwA1hQJBYWw_nsJs6IEF9SJRaYIyc9l1ZJHOwEqf8el5YiIbGch3v8-HwvY-cCrgVAdhMAVKo4CM1TqZCnB2wslESOKPQhG0MugWOWqxE7CWEFEc_F9JiNJIDIEWHMaGY6412oXLeskm5dO--62oR-nXySD0NIqJ3v2-S586becc3a9bEk1vmkf6ek92T6hto-cTZZREdUGU9hGU7ZkTV1oLPdOWFvD_evd0989vL4fHc745XMsOfp3KKeKrJCllBKlHn8JipbpmixtKUWVZmDnotMIZGoslwi6UpblKiFNnLCrrbezruPgUJfNMtQUV2bltwQCoRMTLUEBRG9_IOu3ODbON03BQhaTCMltlQVdxQ82aLzy8b4dSGg2GRQbDMoYgbFJoNYJuxiZx7Khub7Gz9LjwBugRBb7YL879P_W78A1GGSzg</recordid><startdate>20190301</startdate><enddate>20190301</enddate><creator>Landreneau, Joshua P.</creator><creator>Strong, Andrew T.</creator><creator>El-Hayek, Kevin</creator><creator>Tu, Chao</creator><creator>Villamere, James</creator><creator>Ponsky, Jeffrey L.</creator><creator>Kroh, Matthew D.</creator><creator>Rodriguez, John H.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20190301</creationdate><title>Laparoscopic pyloroplasty versus endoscopic per-oral pyloromyotomy for the treatment of gastroparesis</title><author>Landreneau, Joshua P. ; Strong, Andrew T. ; El-Hayek, Kevin ; Tu, Chao ; Villamere, James ; Ponsky, Jeffrey L. ; Kroh, Matthew D. ; Rodriguez, John H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-6df2854ef13b0b323910024fb62f2bfb81cb908d1742ee1c7932e8c8f232818a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Endoscopy</topic><topic>Etiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology</topic><topic>Gastroparesis - surgery</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Natural Orifice Endoscopic Surgery</topic><topic>Proctology</topic><topic>Pyloromyotomy - methods</topic><topic>Pylorus - diagnostic imaging</topic><topic>Pylorus - surgery</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Landreneau, Joshua P.</creatorcontrib><creatorcontrib>Strong, Andrew T.</creatorcontrib><creatorcontrib>El-Hayek, Kevin</creatorcontrib><creatorcontrib>Tu, Chao</creatorcontrib><creatorcontrib>Villamere, James</creatorcontrib><creatorcontrib>Ponsky, Jeffrey L.</creatorcontrib><creatorcontrib>Kroh, Matthew D.</creatorcontrib><creatorcontrib>Rodriguez, John H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Landreneau, Joshua P.</au><au>Strong, Andrew T.</au><au>El-Hayek, Kevin</au><au>Tu, Chao</au><au>Villamere, James</au><au>Ponsky, Jeffrey L.</au><au>Kroh, Matthew D.</au><au>Rodriguez, John H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic pyloroplasty versus endoscopic per-oral pyloromyotomy for the treatment of gastroparesis</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2019-03-01</date><risdate>2019</risdate><volume>33</volume><issue>3</issue><spage>773</spage><epage>781</epage><pages>773-781</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Gastroparesis is a debilitating functional disorder of the stomach characterized by delayed gastric emptying absent an obstructive etiology. Surgical or endoscopic disruption of the pylorus has been utilized to treat this disease, but there is little evidence comparing laparoscopic pyloroplasty (LP) with endoscopic per-oral pyloromyotomy (POP). Herein we describe our experience at our institution using a propensity-matched cohort study to compare outcomes between these procedures.
Methods
All patients who underwent LP for the treatment of gastroparesis from October 2014 through September 2017 at our institution were retrospectively reviewed. Propensity scoring was used to match these patients 1:1 to patients undergoing POP during this time period based on gender, age, and etiology of gastroparesis. Symptom scores using the Gastroparesis Cardinal Symptom Index (GCSI), scintigraphic gastric emptying studies (GES), and perioperative outcomes were compared between matched cohorts. Thirty patients underwent LP for gastroparesis during the study period which were matched 1:1 with patients undergoing POP. The etiology of gastroparesis was 63.3% idiopathic (
n
= 19), 20.0% post-surgical (
n
= 6), and 16.7% diabetic (
n
= 5) in both cohorts.
Results
Patients who underwent LP had a longer average length of stay (4.6 vs. 1.4 days,
p
= 0.003), operative time (99.3 vs. 33.9 min,
p
< 0.001), and estimated blood loss (12.9 vs. 0.4 mL,
p
< 0.001). There were more complications in the LP cohort (16.7 vs. 3.3%,
p
= 0.086), which included surgical site infection (6.7 vs. 0%,
p
= 0.153), pneumonia (6.7 vs. 0.0%,
p
= 0.153), and unplanned ICU admission (10.0 vs. 0.0%,
p
= 0.078). LP and POP both resulted in similar, significant improvements in both in GCSI scores and objective gastric emptying.
Conclusions
Per-oral endoscopic pyloromyotomy (POP) is safe and effective for the treatment of medical refractory gastroparesis. POP has less perioperative morbidity compared to LP with
comparative functional outcomes
.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30019220</pmid><doi>10.1007/s00464-018-6342-6</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0930-2794 |
| ispartof | Surgical endoscopy, 2019-03, Vol.33 (3), p.773-781 |
| issn | 0930-2794 1432-2218 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2071583040 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Adult Aged Endoscopy Etiology Female Follow-Up Studies Gastroenterology Gastroparesis - surgery Gynecology Hepatology Humans Laparoscopy Male Medicine Medicine & Public Health Middle Aged Natural Orifice Endoscopic Surgery Proctology Pyloromyotomy - methods Pylorus - diagnostic imaging Pylorus - surgery Retrospective Studies Surgery Treatment Outcome |
| title | Laparoscopic pyloroplasty versus endoscopic per-oral pyloromyotomy for the treatment of gastroparesis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-19T20%3A01%3A40IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Laparoscopic%20pyloroplasty%20versus%20endoscopic%20per-oral%20pyloromyotomy%20for%20the%20treatment%20of%20gastroparesis&rft.jtitle=Surgical%20endoscopy&rft.au=Landreneau,%20Joshua%20P.&rft.date=2019-03-01&rft.volume=33&rft.issue=3&rft.spage=773&rft.epage=781&rft.pages=773-781&rft.issn=0930-2794&rft.eissn=1432-2218&rft_id=info:doi/10.1007/s00464-018-6342-6&rft_dat=%3Cproquest_cross%3E2071583040%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2071020815&rft_id=info:pmid/30019220&rfr_iscdi=true |