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DOI: 10.1055/s-0042-1744729
G-POEM IN REFRACTORY GASTROPARESIS, FOR WHOM? LONG TERM OUTCOMES AND PREDICTIVE SCORE TO IMPROVE PATIENT SELECTION
Aims Limited data exist concerning the long-term efficiency of G-POEM as a treatment of refractory gastroparesis. This study evaluates the 3-year results of G-POEM in patients with refractory gastroparesis, then investigated predictive factors for procedure success or failure.
Methods This was a prospective multicenter study of all G-POEM operations performed in two expert French centers for refractory gastroparesis with at least 3 years of follow-up (n=46). GCSI was recorded every 6 months during follow-up.
Results Clinical success was 65.2% at 36 months. Median GCSI decreased from 3.33 to 1.80 (p<0.0001) with improvement in all subscales. We create a predictive score concerning G-POEM success or failure to which points were assigned as follows:
|
Criterion |
Score assigned |
|---|---|
|
Nausea subscale<2 |
+1 |
|
Satiety subscale>4 |
+1 |
|
Bloating subscale>3.5 |
+1 |
|
Retention at 4 hours on scintigraphy>50% |
+1 |
A threshold of 2 was identified by receiver operating characteristic curve analysis with an area under the curve of 0.825 that predicted clinical success with 93.3% sensitivity, 56.3% specificity, 80% PPV, 81.8% NPV and 80.4% accuracy. Patients with a score≥2 were significantly more likely to be responders at 3 years than were patients with a score<2 (80% and 18% respectively; p=0.0004).
Conclusions The clinical success of G-POEM for refractory gastroparesis was 65.2% at 36 months. Our predictive score offers an easy tool that should be confirmed in other studies.
Publication History
Article published online:
14 April 2022
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