Surgery · Gastroenterology · 2 h ago
GPOEM clinical success declines by one year after esophagectomy
A prospective two-center study assessed gastric peroral endoscopic pyloromyotomy (GPOEM) in 20 patients with delayed gastric conduit emptying after esophagectomy. Clinical success was 68% at three months and 44% at 12 months; exploratory analyses did not identify significant predictors of response.
- Technical success was 95% in 20 patients.
- Clinical success was 68% at three months.
- At 12 months, clinical success was 44%.
- Exploratory analyses found no significant response predictors.
Delayed gastric conduit emptying can occur after esophagectomy, and treatment is challenging. In this prospective study at two tertiary referral centers, 20 symptomatic patients scheduled for GPOEM were assessed. Clinical success was defined as a score of 1 or 2 on a six-point Likert scale at three months. Investigators also assessed pyloric distensibility, gastric emptying scintigraphy and response to prior pylorus-directed treatment.
GPOEM was technically successful in 19 of 20 patients (95%). Clinical success was reported in 13 of 19 patients at three months (68%; 95% CI 37–84) and 8 of 18 at 12 months (44%; 95% CI 22–67). Baseline pyloric distensibility did not differ significantly between patients with and without clinical success. Differences in gastric retention and prior-treatment response were also not statistically significant.
The findings suggest GPOEM is feasible in this selected population, but the observed clinical success rate declined by one year. The small cohort and exploratory predictor analyses limit conclusions about durability and patient selection. Larger studies are needed to assess whether response to prior pylorus-directed therapy predicts GPOEM outcomes.
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Surgical Endoscopy: Gastric peroral endoscopic pyloromyotomy for delayed gastric conduit emptying: outcomes and predictors of treatment response ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.