D0693 - Short Term Outcomes of Gastric Per Oral Endoscopic Pyloromyotomy (GPOEM) Seven Years Ago and Now

Shazia Rashid, MD¹, Syed Musa Raza, MD², Maryam Mubashir, MD², Allison Derise, MS², Grace McCurdy, MS³, Philip Bouchette, MD², Pooja Shah, MD², Lovekirat Dhaliwal, MD⁴, Tonia Gooden, MD², Tunde Abu bakar, MS², Qiang Cai, MD^1
1LSUHSC, Shreveport, LA; ²Louisiana State University Health Sciences Center, Shreveport, LA; ³Ochsner LSU Health Shreveport, Shreveport, LA; ⁴Oschner LSU Health Shreveport, Shreveport, LA

Introduction: Gastric per oral endoscopic pyloromyotomy (GPOEM) has been performed in the last seven years or so. Many studies have shown that GPOEM is 80% effective in reducing nausea and vomiting in patients with refractory gastroparesis (Gp) with mean procedure time of about 1 hr. However, all reported outcomes of GPOEM were from the earlier stage of performed patients. In this study, we compare the short-term outcomes of our first and recent 16 patients.

Methods: Our first 16 patients who underwent GPOEM from 06/2015 to 07/2016 (Group A) and our recent 16 patients from 07/2021 to 01/2022 (Group B) were enrolled in the study. Patients’ demographics, clinic outcomes of GPOEM and procedure time were compared between the two groups. Clinical success was defined as an improvement in symptoms as measured by a decrease in mean GCSI and a significant decrease in at least 2 subsets of cardinal symptoms. The procedure time was defined as the duration from scope in and scope out. All procedures were performed by QC (who performed a hundred POEM before his first GPOEM).

Results: The mean age for group A and group B were 44.8 + 14.8 and 47.8 + 18.8 years. Group A had 13 female pts; group B had 12. The number of diabetic, idiopathic and post-surgical Gp were 9, 5, 2 for Group A and 8, 4 and 4 for Group B. All pts failed medical treatment. Four patients in Group A and one patient in Group B had gastric electrical stimulator. In Group A, 13 out of 16 pts (81%) had a significant improvement in the mean GCSI after GPOEM: 3.40 + 0.50 before the procedure (n= 16) to 1.48 + 0.95 (P < 0.0001) at 1 month (n= 16). In Group B, 14 out of 16 pts (88%) had significant improvement in the mean GCSI after GPOEM: 3.35 + 0.70 before the procedure (n=16) to 1.51 + 0.82 (P < 0.0001) at 56 + 22.6 days (n=15; one pt had no follow up). There were no significant differences between the two group in terms of pts demographics and short clinical outcomes. There was a significant difference in procedure time and the length of hospital stay (LOS) between the two groups: the procedure times were 49.7 + 22.1 and 29.6 + 10.1 minutes for Group A and Group B respectively. The LOS were 2.47 + 0.7 and 1.18 + 0.4 days respectively. No adverse events were reported for both groups.

Discussion: For an experienced submucosal endoscopist, there were no differences between the short- term clinical outcomes of GPOEM between 7 years ago and now. However, the procedure time and the length of hospital stay was significantly shorter after 7 years of practice.


Disclosures:


Shazia Rashid, MD¹, Syed Musa Raza, MD², Maryam Mubashir, MD², Allison Derise, MS², Grace McCurdy, MS³, Philip Bouchette, MD², Pooja Shah, MD², Lovekirat Dhaliwal, MD⁴, Tonia Gooden, MD², Tunde Abu bakar, MS², Qiang Cai, MD¹. D0693 - Short Term Outcomes of Gastric Per Oral Endoscopic Pyloromyotomy (GPOEM) Seven Years Ago and Now, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.