Feasibility, safety, and long-term efficacy of gastric peroral endoscopic myotomy (G-POEM) for postsurgical gastroparesis: a single-center and retrospective study of a prospective database
Background Postsurgical gastroparesis is recognized as a gastrointestinal dysfunction syndrome following foregut surgery. Gastric peroral endoscopic myotomy (G-POEM) is suggested as a minimally invasive therapy for gastroparesis. But the long-term efficacy and safety of G-POEM in treating postsurgic...
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| Veröffentlicht in: | Surgical endoscopy 2021-07, Vol.35 (7), p.3459-3470 |
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| creator | Tan, Jiacheng Shrestha, Sachin Mulmi Wei, Ming Wang, Panpan Shi, Jinjun Lu, Yanjia Gao, Qi Lu, Tong Zhou, Jun Shi, Ruihua |
| description | Background
Postsurgical gastroparesis is recognized as a gastrointestinal dysfunction syndrome following foregut surgery. Gastric peroral endoscopic myotomy (G-POEM) is suggested as a minimally invasive therapy for gastroparesis. But the long-term efficacy and safety of G-POEM in treating postsurgical gastroparesis are rarely explored.
Methods
The primary outcomes included the symptomatic improvement based on gastroparesis cardinal symptoms index (GCSI) and the improvement of gastric emptying. The secondary outcomes included the improvement of gastroesophageal reflux symptoms and complications of G-POEM.
Results
The severity of postsurgical gastroparesis was not associated with the onset time and the course of the disease. G-POEM significantly reduced GCSI throughout the follow-up period (
p
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| doi_str_mv | 10.1007/s00464-020-07793-0 |
| format | Article |
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Postsurgical gastroparesis is recognized as a gastrointestinal dysfunction syndrome following foregut surgery. Gastric peroral endoscopic myotomy (G-POEM) is suggested as a minimally invasive therapy for gastroparesis. But the long-term efficacy and safety of G-POEM in treating postsurgical gastroparesis are rarely explored.
Methods
The primary outcomes included the symptomatic improvement based on gastroparesis cardinal symptoms index (GCSI) and the improvement of gastric emptying. The secondary outcomes included the improvement of gastroesophageal reflux symptoms and complications of G-POEM.
Results
The severity of postsurgical gastroparesis was not associated with the onset time and the course of the disease. G-POEM significantly reduced GCSI throughout the follow-up period (
p
< 0.0001). For different anastomotic site, a significant improvement of GCSI was found at 6 month post-G-POEM (
F
4,165
= 74.18,
p
< 0.0001). Subscale analysis of GCSI showed that nausea/vomiting, post-prandial fullness/early satiety, and bloating were improved significantly at 6-month post-G-POEM (
p
< 0.0001, respectively). Half-emptying and whole-emptying time were significantly shortened in patients with different anastomotic site post-G-POEM (half-emptying time:
F
3,174
= 65.44,
p
< 0.0001; whole-emptying time:
F
3,174
= 54.85,
p
< 0.0001). The emptying of ioversol was obviously accelerated after G-POEM. GCSI wasn't related to pyloric length, pyloric diameter, and thickness of pyloric wall. GERDQ was also used to evaluate the clinical efficacy of G-POEM. For each time points, GERDQ didn't differ significantly in patients with different anastomotic site (
F
4,104
= 0.8075,
p
= 0.5231). For patients with different anastomotic site, GERDQ was improved significantly at different time points (
F
4,104
= 59.11,
p
< 0.0001). The higher the esophageal anastomotic site was, the faster G-POEM improved the symptoms of gastroesophageal reflux. No one required re-hospitalization for any complication.
Conclusion
G-POEM is a minimally invasive therapy with long-term effectiveness and safety in treating postsurgical gastroparesis.]]></description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-020-07793-0</identifier><identifier>PMID: 32880749</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Botulinum toxin ; Disease ; Endoscopy ; Esophagus ; Gastroenterology ; Gastroesophageal reflux ; General anesthesia ; Gynecology ; Hepatology ; Hospitals ; Medicine ; Medicine & Public Health ; Nausea ; Proctology ; Retention ; Stomach ; Surgery ; Ultrasonic imaging</subject><ispartof>Surgical endoscopy, 2021-07, Vol.35 (7), p.3459-3470</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-cb80d94aa81c1bc1efa694a3f8ce7b383f3548b6438e72c8f7e210d53aaf4f3d3</citedby><cites>FETCH-LOGICAL-c451t-cb80d94aa81c1bc1efa694a3f8ce7b383f3548b6438e72c8f7e210d53aaf4f3d3</cites><orcidid>0000-0003-4977-8801</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-020-07793-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-020-07793-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Tan, Jiacheng</creatorcontrib><creatorcontrib>Shrestha, Sachin Mulmi</creatorcontrib><creatorcontrib>Wei, Ming</creatorcontrib><creatorcontrib>Wang, Panpan</creatorcontrib><creatorcontrib>Shi, Jinjun</creatorcontrib><creatorcontrib>Lu, Yanjia</creatorcontrib><creatorcontrib>Gao, Qi</creatorcontrib><creatorcontrib>Lu, Tong</creatorcontrib><creatorcontrib>Zhou, Jun</creatorcontrib><creatorcontrib>Shi, Ruihua</creatorcontrib><title>Feasibility, safety, and long-term efficacy of gastric peroral endoscopic myotomy (G-POEM) for postsurgical gastroparesis: a single-center and retrospective study of a prospective database</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><description><![CDATA[Background
Postsurgical gastroparesis is recognized as a gastrointestinal dysfunction syndrome following foregut surgery. Gastric peroral endoscopic myotomy (G-POEM) is suggested as a minimally invasive therapy for gastroparesis. But the long-term efficacy and safety of G-POEM in treating postsurgical gastroparesis are rarely explored.
Methods
The primary outcomes included the symptomatic improvement based on gastroparesis cardinal symptoms index (GCSI) and the improvement of gastric emptying. The secondary outcomes included the improvement of gastroesophageal reflux symptoms and complications of G-POEM.
Results
The severity of postsurgical gastroparesis was not associated with the onset time and the course of the disease. G-POEM significantly reduced GCSI throughout the follow-up period (
p
< 0.0001). For different anastomotic site, a significant improvement of GCSI was found at 6 month post-G-POEM (
F
4,165
= 74.18,
p
< 0.0001). Subscale analysis of GCSI showed that nausea/vomiting, post-prandial fullness/early satiety, and bloating were improved significantly at 6-month post-G-POEM (
p
< 0.0001, respectively). Half-emptying and whole-emptying time were significantly shortened in patients with different anastomotic site post-G-POEM (half-emptying time:
F
3,174
= 65.44,
p
< 0.0001; whole-emptying time:
F
3,174
= 54.85,
p
< 0.0001). The emptying of ioversol was obviously accelerated after G-POEM. GCSI wasn't related to pyloric length, pyloric diameter, and thickness of pyloric wall. GERDQ was also used to evaluate the clinical efficacy of G-POEM. For each time points, GERDQ didn't differ significantly in patients with different anastomotic site (
F
4,104
= 0.8075,
p
= 0.5231). For patients with different anastomotic site, GERDQ was improved significantly at different time points (
F
4,104
= 59.11,
p
< 0.0001). The higher the esophageal anastomotic site was, the faster G-POEM improved the symptoms of gastroesophageal reflux. No one required re-hospitalization for any complication.
Conclusion
G-POEM is a minimally invasive therapy with long-term effectiveness and safety in treating postsurgical gastroparesis.]]></description><subject>Abdominal Surgery</subject><subject>Botulinum toxin</subject><subject>Disease</subject><subject>Endoscopy</subject><subject>Esophagus</subject><subject>Gastroenterology</subject><subject>Gastroesophageal reflux</subject><subject>General anesthesia</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nausea</subject><subject>Proctology</subject><subject>Retention</subject><subject>Stomach</subject><subject>Surgery</subject><subject>Ultrasonic imaging</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kk1v1DAQhiMEokvhD3CyxKVIGPyVjc0BCVVtQSoqBzhbjjMOrpI4eJJK-9_4cXh3K74OnEYeP_POjP1W1XPOXnPGmjfImNoqygSjrGmMpOxBteFKCioE1w-rDTOSUdEYdVI9QbxlhTe8flydSKE1a5TZVD8uwWFs4xCX3SuCLsA-uqkjQ5p6ukAeCYQQvfM7kgLpHS45ejJDTtkNBKYuoU9zSY27tKRxR86u6Oebi08vSUiZzAkXXHNfBIZjcZpdBoz4ljiCceoHoB6m0ujQNUMhcAa_xDsguKzdoa0j8x_pzi2udQhPq0fBDQjP7uNp9fXy4sv5B3p9c_Xx_P019armC_WtZp1Rzmnuees5BLctRxm0h6aVWgZZK91uldTQCK9DA4KzrpbOBRVkJ0-rd0fdeW1H6Pbjlt3tnOPo8s4mF-3fN1P8Zvt0ZzU3tdmyInB2L5DT9xVwsWNED8PgJkgrWqGkMU0Zao---Ae9TWueynpW1Kp8oZTCFEocKV-eBTOEX8NwZvfmsEdz2GIOezCH3UvLYxEWeOoh_5b-T9VPLXPAsw</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Tan, Jiacheng</creator><creator>Shrestha, Sachin Mulmi</creator><creator>Wei, Ming</creator><creator>Wang, Panpan</creator><creator>Shi, Jinjun</creator><creator>Lu, Yanjia</creator><creator>Gao, Qi</creator><creator>Lu, Tong</creator><creator>Zhou, Jun</creator><creator>Shi, Ruihua</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</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><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4977-8801</orcidid></search><sort><creationdate>20210701</creationdate><title>Feasibility, safety, and long-term efficacy of gastric peroral endoscopic myotomy (G-POEM) for postsurgical gastroparesis: a single-center and retrospective study of a prospective database</title><author>Tan, Jiacheng ; Shrestha, Sachin Mulmi ; Wei, Ming ; Wang, Panpan ; Shi, Jinjun ; Lu, Yanjia ; Gao, Qi ; Lu, Tong ; Zhou, Jun ; Shi, Ruihua</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-cb80d94aa81c1bc1efa694a3f8ce7b383f3548b6438e72c8f7e210d53aaf4f3d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Abdominal Surgery</topic><topic>Botulinum toxin</topic><topic>Disease</topic><topic>Endoscopy</topic><topic>Esophagus</topic><topic>Gastroenterology</topic><topic>Gastroesophageal reflux</topic><topic>General anesthesia</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hospitals</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nausea</topic><topic>Proctology</topic><topic>Retention</topic><topic>Stomach</topic><topic>Surgery</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tan, Jiacheng</creatorcontrib><creatorcontrib>Shrestha, Sachin Mulmi</creatorcontrib><creatorcontrib>Wei, Ming</creatorcontrib><creatorcontrib>Wang, Panpan</creatorcontrib><creatorcontrib>Shi, Jinjun</creatorcontrib><creatorcontrib>Lu, Yanjia</creatorcontrib><creatorcontrib>Gao, Qi</creatorcontrib><creatorcontrib>Lu, Tong</creatorcontrib><creatorcontrib>Zhou, Jun</creatorcontrib><creatorcontrib>Shi, Ruihua</creatorcontrib><collection>Springer Nature OA Free Journals</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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tan, Jiacheng</au><au>Shrestha, Sachin Mulmi</au><au>Wei, Ming</au><au>Wang, Panpan</au><au>Shi, Jinjun</au><au>Lu, Yanjia</au><au>Gao, Qi</au><au>Lu, Tong</au><au>Zhou, Jun</au><au>Shi, Ruihua</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feasibility, safety, and long-term efficacy of gastric peroral endoscopic myotomy (G-POEM) for postsurgical gastroparesis: a single-center and retrospective study of a prospective database</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><date>2021-07-01</date><risdate>2021</risdate><volume>35</volume><issue>7</issue><spage>3459</spage><epage>3470</epage><pages>3459-3470</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract><![CDATA[Background
Postsurgical gastroparesis is recognized as a gastrointestinal dysfunction syndrome following foregut surgery. Gastric peroral endoscopic myotomy (G-POEM) is suggested as a minimally invasive therapy for gastroparesis. But the long-term efficacy and safety of G-POEM in treating postsurgical gastroparesis are rarely explored.
Methods
The primary outcomes included the symptomatic improvement based on gastroparesis cardinal symptoms index (GCSI) and the improvement of gastric emptying. The secondary outcomes included the improvement of gastroesophageal reflux symptoms and complications of G-POEM.
Results
The severity of postsurgical gastroparesis was not associated with the onset time and the course of the disease. G-POEM significantly reduced GCSI throughout the follow-up period (
p
< 0.0001). For different anastomotic site, a significant improvement of GCSI was found at 6 month post-G-POEM (
F
4,165
= 74.18,
p
< 0.0001). Subscale analysis of GCSI showed that nausea/vomiting, post-prandial fullness/early satiety, and bloating were improved significantly at 6-month post-G-POEM (
p
< 0.0001, respectively). Half-emptying and whole-emptying time were significantly shortened in patients with different anastomotic site post-G-POEM (half-emptying time:
F
3,174
= 65.44,
p
< 0.0001; whole-emptying time:
F
3,174
= 54.85,
p
< 0.0001). The emptying of ioversol was obviously accelerated after G-POEM. GCSI wasn't related to pyloric length, pyloric diameter, and thickness of pyloric wall. GERDQ was also used to evaluate the clinical efficacy of G-POEM. For each time points, GERDQ didn't differ significantly in patients with different anastomotic site (
F
4,104
= 0.8075,
p
= 0.5231). For patients with different anastomotic site, GERDQ was improved significantly at different time points (
F
4,104
= 59.11,
p
< 0.0001). The higher the esophageal anastomotic site was, the faster G-POEM improved the symptoms of gastroesophageal reflux. No one required re-hospitalization for any complication.
Conclusion
G-POEM is a minimally invasive therapy with long-term effectiveness and safety in treating postsurgical gastroparesis.]]></abstract><cop>New York</cop><pub>Springer US</pub><pmid>32880749</pmid><doi>10.1007/s00464-020-07793-0</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-4977-8801</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0930-2794 |
| ispartof | Surgical endoscopy, 2021-07, Vol.35 (7), p.3459-3470 |
| issn | 0930-2794 1432-2218 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8195960 |
| source | SpringerLink Journals |
| subjects | Abdominal Surgery Botulinum toxin Disease Endoscopy Esophagus Gastroenterology Gastroesophageal reflux General anesthesia Gynecology Hepatology Hospitals Medicine Medicine & Public Health Nausea Proctology Retention Stomach Surgery Ultrasonic imaging |
| title | Feasibility, safety, and long-term efficacy of gastric peroral endoscopic myotomy (G-POEM) for postsurgical gastroparesis: a single-center and retrospective study of a prospective database |
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