Systematic review with meta‐analysis: one‐year outcomes of gastric peroral endoscopic myotomy for refractory gastroparesis. Issue 2 (1st December 2021)

• Record Type: Journal Article
• Authors: Kamal, Faisal; Khan, Muhammad Ali; Lee‐Smith, Wade; Sharma, Sachit; Acharya, Ashu; Jowhar, Dawit; Farooq, Umer; Aziz, Muhammad; Kouanda, Abdul; Dai, Sun‐Chuan; Howden, Colin W.; Munroe, Craig A.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 55:Issue 2(2022)
• Page Start: 168
• Page End: 177
• Publication Date: 2021-12-01
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.16725
• Languages: English
• ISSNs: 0269-2813

Abstract

Summary: Background: Several studies have examined the efficacy of gastric peroral endoscopic myotomy (G‐POEM) for gastroparesis. Aim: To evaluate the mid‐term efficacy of G‐POEM by meta‐analysis of studies with a minimum 1 year of follow‐up. Methods: We reviewed several databases from inception to 10 June 2021 to identify studies that evaluated the efficacy of G‐POEM in refractory gastroparesis, and had at least 1 year of follow‐up. Our outcomes of interest were clinical success at 1 year, adverse events, difference in mean pre‐ and 1 year post‐procedure Gastroparesis Cardinal Symptom Index (GCSI) score, and difference in mean pre‐ and post‐procedure EndoFLIP measurements. We analysed data using a random‐effects model and assessed heterogeneity by I 2 statistic. Results: We included 10 studies comprising 482 patients. Pooled rates (95% CI) of clinical success at 1 year and adverse events were 61% (49%, 71%) and 8% (6%, 11%), respectively. Mean GCSI at 1 year post‐procedure was significantly lower than pre‐procedure; mean difference (MD) (95% CI) −1.4 (−1.9, −0.9). Mean post‐procedure distensibility index was significantly higher than pre‐procedure in the clinical success group at 40 and 50 mL volume distension; standardised mean difference (95% CI) 0.82 (0.07, 1.64) and 0.91 (0.32, 1.49), respectively. In the clinical failure group, there was no significant difference between mean pre‐ and post‐procedure EndoFLIP measurements. Conclusions: G‐POEM is associated with modest clinical success at 1 year. Additional studies with longer follow‐up are required to evaluate its longer‐term efficacy. Abstract : Systematic review and Meta‐analysis: One‐year outcomes of gastric peroral endoscopic myotomy for refractory gastroparesis.