Severe and Refractory gastroparesis can be treated with endoscopic pyloromyotomy: BMJ

Written By : Jacinthlyn Sylvia |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-03-24T20:00:43+05:30 | Updated On 24 March 2023 8:01 PM IST

A recent study finds endoscopic pyloromyotomy (G-POEM), a minimally invasive treatment option for patients with gastroparesis, improves the symptoms and also gastric emptying 6 months post procedure. The findings were published in British Medical Journal - Gut.

This prospective randomized trial compared G-POEM with sham in patients with severe gastroparesis. The primary outcome was the proportion of patients with treatment success (defined as a reduction of at least 50% in the Gastroparesis Cardinal Symptom Index (GCSI) at 6 months). Patients were randomized to the sham group with persistent symptoms and offered crossover G-POEM. Enrollment was suspended after an interim analysis by the Information and Security Control Authority prior to the planned sample of 86 patients.

The key highlights of the study were:

A total of 41 patients (17 diabetic, 13 postoperative, 11 idiopathic; 6% male) were randomized into G-POEM and sham groups (21:20).

The treatment success rates were 71% (95% CI 50-86) after G-POEM and 22% (8-47) after sham (p = 0.005).

Treatment success rates in patients with diabetic, postoperative and idiopathic gastroparesis were 89% (95% CI 56–98), 50% (18 - 82) and 67% (30 - 90) after G-POEM; In the sham group, the corresponding figures were 17% (3-57), 29% (7-67) and 20% (3-67).

Mean gastric retention at 4 hours decreased from 22% (95% CI 17-31) to 12% (5-22) after G-POEM and was unchanged after sham: 26% (18-39) vs. 24% (11–35).

12 patients underwent G-POEM treatment, of which 9 (75%) were successful.

G-POEM for severe gastroparesis was superior to sham procedures in improving both symptoms and gastric emptying 6 months after the procedure according to the extensive findings of this study.

Source:

Martinek, J., Hustak, R., Mares, J., Vackova, Z., Spicak, J., Kieslichova, E., Buncova, M., Pohl, D., Amin, S., & Tack, J. (2022). Endoscopic pyloromyotomy for the treatment of severe and refractory gastroparesis: a pilot, randomised, sham-controlled trial. Gut, 71(11), 2170–2178. https://doi.org/10.1136/gutjnl-2022-326904

endoscopic pyloromyotomyBMJ Gutgastroparesis

Source : BMJ Gut

Jacinthlyn Sylvia

Neuroscience Masters graduate

Jacinthlyn Sylvia, a Neuroscience Master's graduate from Chennai has worked extensively in deciphering the neurobiology of cognition and motor control in aging. She also has spread-out exposure to Neurosurgery from her Bachelor’s. She is currently involved in active Neuro-Oncology research. She is an upcoming neuroscientist with a fiery passion for writing. Her news cover at Medical Dialogues feature recent discoveries and updates from the healthcare and biomedical research fields. She can be reached at editorial@medicaldialogues.in

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751