P2745 - Long Term Outcomes (≥ 3 Years) Following Gastric Peroral Endoscopic Myotomy for Gastroparesis: A Systematic Review and Meta-Analysis

Award: Presidential Poster Award

Justin Canakis, DO¹, Smit Deliwala, MD², Michael Frohlinger, MD³, Andrew Canakis, DO³, Douglas G. Adler, MD^4
1George Washington University School of Medicine and Health Sciences, Washington, DC; ²Emory University School of Medicine, Atlanta, GA; ³University of Maryland School of Medicine, Baltimore, MD; ⁴Center for Advanced Therapeutic (CATE), Centura Health, Porter Adventist Hospital, Peak Gastroenterology, Denver, CO

Introduction: Gastric peroral endoscopic myotomy (G-POEM) has emerged as a novel
management option for patients with refractory gastroparesis. G-POEM targets pyloric
distensibility, which is associated with delayed emptying and symptom severity. Compared to the
invasiveness of surgery, G-POEM is a minimally invasive alternative with similar outcomes and
lower complication rate. While G-POEM has demonstrated excellent short-term outcomes,
clinical success with symptom resolution in the long-term setting is still being investigated. As
such, our aim was to investigate long term outcomes following G-POEM in patients with
gastroparesis.

Methods: Multiple databases were searched for studies looking at long term (≥ 3 years) for
gastroparesis patients treated with G-POEM from inception until March 2023. The primary

outcome was clinical success three years after G-POEM. Secondary outcomes included changes
in Gastroparesis Cardinal Symptom Index (GCSI) score before and 36 months after G-POEM,
technical success, adverse events, and length of hospital stay.

Results: Five studies were included with 560 patients (average age of 47.03 years, 67.8%
Female) over a mean follow up of 38.4 months (Table 1). The pooled rate of clinical success at
36 months was 75% (95% CI 68.2 – 80.5, I 2 20%) (Figure 1). The mean values of GCSI
significantly decreased 36 months after the procedure (SMD 3.3 (95% CI 1.8 – 4.7, I 2 94%). The
pooled rate of technical success was 98.6% (95% CI 91 – 99.8, I 2 = 70%). Adverse events
included: perforation 0.7% (95% CI 0.2 – 2.4, I 2 0), bleeding 4.1% (95% CI 2.7 – 6.3, I 2 0), pain
0.9% (, 95% CI 0.3 – 3.1, I 2 0)] and others (i.e. clip dislodgement, prepyloric ulcer, or mucosal
tear) 3.4% (95% CI 2.1 – 5.5, I 2 0). The mean duration of hospital stay was 3.06 days (95% CI
2.6 – 3.5, I 2 91%).

Discussion: This meta-analysis found that G-POEM is a safe and effective long-term treatment
for refractory gastroparesis with a technical and clinical success rate of 98.6% and 75%,
respectively. G-POEM demonstrated a durable effect at 36 months with minimal adverse events.
Further studies are needed to determine patient selection factors that can predict long term
success.



Disclosures:


Justin Canakis, DO¹, Smit Deliwala, MD², Michael Frohlinger, MD³, Andrew Canakis, DO³, Douglas G. Adler, MD⁴. P2745 - Long Term Outcomes (≥ 3 Years) Following Gastric Peroral Endoscopic Myotomy for Gastroparesis: A Systematic Review and Meta-Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.