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Safety and feasibility of same day discharge after per oral endoscopic pyloromyotomy in refractory gastroparesis: a pilot study

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Chinese Medical Journal 2022年第12期135卷 1432-1437页

作者： Rushikesh Shah Huimin Chen Lucie F.Calderon Tonia Gooden Maryam Mubashir Shazia Rashid Syed Musa Raza Allison Derise Grace Mccurdy brenna sanders Steve Keilin Qiang Cai Division of Digestive Diseases Emory University School of MedicineAtlantaGAUSA Division of Gastroenterology and Hepatology Shanghai nsitute of Digestive DiseaseRenj HospitalShanghai JjaoTong University School of MedicineShanghai 200127China Division of Gastroenterology and Hepatology Louisiana State UniversitShreveportLAUSA

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 wi

关键词： G-POEM Pyloromyotomy Gastroparesis Gastric per-oral pyloromyotomy

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