Key points are not available for this paper at this time.
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.
Kamal et al. (Wed,) studied this question.