The following is a summary of “Efficacy and Safety of Gastric Per-Oral Endoscopic Myotomy (G-POEM): A Systematic Review and Meta-Analysis,” published in the April 2024 issue of Gastroenterology by Dolan et al.
Gaining traction as a treatment, gastric per-oral endoscopic myotomy (G-POEM) offers a minimally invasive approach for severe gastroparesis.
Researchers conducted a retrospective study to assess G-POEM’s efficacy and safety in treating gastroparesis.
They crafted personalized search tactics (February 2021), aligning with PRISMA and MOOSE standards. The meta-analysis involved computing pooled proportions and mean differences before and after procedures, utilizing random effects models for rate estimation. The study assessed technical and clinical success, improvement in GCSI, changes in gastric emptying rate, FLIP assessment, and AEs.
The result included 20 studies (n=797 patients; 67.41% female). The average age was 48.92±11.61 years, with an average duration of 4.24±1.11 years since gastroparesis diagnosis. Technical success stood at 98.47% [(95% CI: 97.14, 99.19);I2=0.00] with an average myotomy length of 3.78±1.16 cm. Pre-procedure GCSI scores averaged 3.38±0.37 and significantly improved postprocedure [WMD -1.56 (95% CI: −1.89 to −1.24); I2=82.53; P<0.001]. Gastric retention after 4 hours showed approximately 50% improvement (pre-procedure 43.08±9.24% vs. post-procedure 22.97±10.19%; P<0.001). The FLIP assessment with 40 mL and 50 mL balloons exhibited a noteworthy increase in diameter, distensibility index, and cross-sectional area postprocedure (all P<0.05). The patients AEs linked to the procedure occurred in 10.92% [(95% CI 5.09 to 19.32); I2=82.85].
Investigators concluded that G-POEM offered a safe and significant benefit for patients with severe gastroparesis, improving outcomes regardless of the type of symptoms or underlying cause.
Source: journals.lww.com/jcge/abstract/9900/efficacy_and_safety_of_gastric_per_oral_endoscopic.293.aspx
