Safety and feasibility of same day discharge after per oral endoscopic pyloromyotomy in refractory gastroparesis: a pilot study
10.1097/CM9.0000000000002068
- VernacularTitle:Safety and feasibility of same day discharge after per oral endoscopic pyloromyotomy in refractory gastroparesis: a pilot study
- Author:
Rushikesh SHAH
1
;
Huimin CHEN
;
F. Lucie CALDERON
;
Tonia GOODEN
;
Maryam MUBASHIR
;
Shazia RASHID
;
Musa Syed RAZA
;
Allison DERISE
;
Grace MCCURDY
;
Brenna SANDERS
;
Steve KEILIN
;
Qiang CAI
Author Information
1. Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA, USA
- Keywords:
G-POEM;
Pyloromyotomy;
Gastroparesis;
Gastric per-oral pyloromyotomy
- From:
Chinese Medical Journal
2022;135(12):1432-1437
- CountryChina
- Language:Chinese
-
Abstract:
Background::Gastroparesis is a debilitating medical condition with limited treatment options. Gastric per-oral pyloromyotomy (G-POEM) has emerged as a promising treatment option with remarkable short-term clinical success shown in multiple studies. While the post-procedure protocol is not standardized across many centers, the majority of the centers observes these patients in the hospital after the procedure for monitoring. In this single-center prospective study, we evaluated the safety and feasibility of same day discharge after the G-POEM procedure.Methods::All the patients with refractory gastroparesis undergoing G-POEM from October 2019 to March 2020 were enrolled. A total of 25 patients were enrolled in the procedure. Based on the pre-defined criteria, patients were either discharged on the same day after the procedure or admitted to the hospital for further observation. The patient and procedure-related data were extracted from the chart review. Univariate analysis was performed (chi-squared test) on categorical variables after organizing categorical variables as numeric counts or percentages. The student t test was performed on continuous variables after reporting as mean and standard deviation. For analysis with a smaller sample size, Fisher exact and Mann–Whitney tests were used. Results::A total of 25 patients were enrolled. The technical success of G-POEM was 100% and clinical success was 80% (20/25) at 1-month follow-up. Of the 25 patients, 9 patients (36%) were discharged on the same day according to the procedure from the recovery unit. Of the remaining 16 patients who were admitted to the hospital post-procedure, 10 (40%) were admitted due to procedure-related causes while other admissions were either pre-planned or due to social reasons. The average Charlson comorbidity index was lower in the same day discharge group ( P < 0.05). The number of patients requiring double myotomy was higher in the same day discharge group ( P < 0.05). The overall complication rate of G-POEM in the study cohort was 12% (3/25) with all complications being mild without any severe adverse events. Conclusion::G-POEM is a safe and effective method of treatment for refractory GP with higher clinical success in short-term follow-up. The same day discharge after G-POEM is safe and feasible in >50% of patients with close periprocedural monitoring.
