One-year results of gastric peroral ...
Document type :
Article dans une revue scientifique: Article original
DOI :
Title :
One-year results of gastric peroral endoscopic myotomy for refractory gastroparesis: a French multicenter study
Author(s) :
Ragi, Olivier [Auteur]
Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges]
Jacques, Jérémie [Auteur]
CHU Limoges
XLIM [XLIM]
Branche, Julien [Auteur]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U 1011 [RNMCD]
Leblanc, Sarah [Auteur]
Université Paris Descartes - Paris 5 [UPD5]
Vanbiervliet, Geoffroy [Auteur]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Legros, Romain [Auteur]
Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges]
Pioche, Mathieu [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Rivory, Jérôme [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Chaussade, Stanislas [Auteur]
Université Sorbonne Paris Cité [USPC]
Hôpital Cochin [AP-HP]
Barret, Maximilien [Auteur]
Service de Gastro-entérologie [CHU Cochin]
Wallenhorst, Timothée [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Barthet, Marc [Auteur]
Service d'hépatologie et de gastroentérologie [Hôpital Saint-Joseph - Marseille]
Kerever, Sébastien [Auteur]
Equipe 2 : ECSTRA - Epidémiologie Clinique, STatistique, pour la Recherche en Santé [CRESS - U1153]
Gonzalez, Jean-Michel [Auteur]
Service d'hépatologie et de gastroentérologie [Hôpital Saint-Joseph - Marseille]
Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges]
Jacques, Jérémie [Auteur]
CHU Limoges
XLIM [XLIM]
Branche, Julien [Auteur]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U 1011 [RNMCD]
Leblanc, Sarah [Auteur]
Université Paris Descartes - Paris 5 [UPD5]
Vanbiervliet, Geoffroy [Auteur]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Legros, Romain [Auteur]
Service d'Hépato-gastro-entérologie et Nutrition [CHU Dupuytren 1, Limoges]
Pioche, Mathieu [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Rivory, Jérôme [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Chaussade, Stanislas [Auteur]
Université Sorbonne Paris Cité [USPC]
Hôpital Cochin [AP-HP]
Barret, Maximilien [Auteur]
Service de Gastro-entérologie [CHU Cochin]
Wallenhorst, Timothée [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Barthet, Marc [Auteur]
Service d'hépatologie et de gastroentérologie [Hôpital Saint-Joseph - Marseille]
Kerever, Sébastien [Auteur]
Equipe 2 : ECSTRA - Epidémiologie Clinique, STatistique, pour la Recherche en Santé [CRESS - U1153]
Gonzalez, Jean-Michel [Auteur]
Service d'hépatologie et de gastroentérologie [Hôpital Saint-Joseph - Marseille]
Journal title :
Endoscopy
Pages :
480-490
Publisher :
Thieme Publishing
Publication date :
2020-06-23
ISSN :
0013-726X
HAL domain(s) :
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Hépatologie et Gastroentérologie
English abstract : [en]
Abstract Background: Data on the long-term outcomes of gastric peroral endoscopic myotomy (G-POEM) for refractory gastroparesis are lacking. We report the results of a large multicenter long-term follow-up study of G-POEM ...
Show more >Abstract Background: Data on the long-term outcomes of gastric peroral endoscopic myotomy (G-POEM) for refractory gastroparesis are lacking. We report the results of a large multicenter long-term follow-up study of G-POEM for refractory gastroparesis. Methods: This was a retrospective multicenter study of all G-POEM operations performed in seven expert French centers for refractory gastroparesis with at least 1 year of follow-up. The primary endpoint was the 1-year clinical success rate, defined as at least a 1-point improvement in the Gastroparesis Cardinal Symptom Index (GCSI). Results: 76 patients were included (60.5 % women; age 56 years). The median symptom duration was 48 months. The median gastric retention at 4 hours (H4) before G-POEM was 45 % (interquartile range [IQR] 29 % – 67 %). The median GCSI before G-POEM was 3.6 (IQR 2.8 – 4.0). Clinical success was achieved in 65.8 % of the patients at 1 year, with a median rate of reduction in the GCSI score of 41 %. In logistic regression analysis, only a high preoperative GCSI satiety subscale score was predictive of clinical success (odds ratio [OR] 3.41, 95 % confidence interval [CI] 1.01 – 11.54; P = 0.048), while a high rate of gastric retention at H4 was significantly associated with clinical failure (OR 0.97, 95 %CI 0.95 – 1.00; P = 0.03). Conclusions: The results confirm the efficacy of G-POEM for the treatment of refractory gastroparesis, as evidenced by a 65.8 % clinical success rate at 1 year. Although G-POEM is promising, prospective sham-controlled trials are urgently needed to confirm its efficacy and identify the patient populations who will benefit most from this procedure.Show less >
Show more >Abstract Background: Data on the long-term outcomes of gastric peroral endoscopic myotomy (G-POEM) for refractory gastroparesis are lacking. We report the results of a large multicenter long-term follow-up study of G-POEM for refractory gastroparesis. Methods: This was a retrospective multicenter study of all G-POEM operations performed in seven expert French centers for refractory gastroparesis with at least 1 year of follow-up. The primary endpoint was the 1-year clinical success rate, defined as at least a 1-point improvement in the Gastroparesis Cardinal Symptom Index (GCSI). Results: 76 patients were included (60.5 % women; age 56 years). The median symptom duration was 48 months. The median gastric retention at 4 hours (H4) before G-POEM was 45 % (interquartile range [IQR] 29 % – 67 %). The median GCSI before G-POEM was 3.6 (IQR 2.8 – 4.0). Clinical success was achieved in 65.8 % of the patients at 1 year, with a median rate of reduction in the GCSI score of 41 %. In logistic regression analysis, only a high preoperative GCSI satiety subscale score was predictive of clinical success (odds ratio [OR] 3.41, 95 % confidence interval [CI] 1.01 – 11.54; P = 0.048), while a high rate of gastric retention at H4 was significantly associated with clinical failure (OR 0.97, 95 %CI 0.95 – 1.00; P = 0.03). Conclusions: The results confirm the efficacy of G-POEM for the treatment of refractory gastroparesis, as evidenced by a 65.8 % clinical success rate at 1 year. Although G-POEM is promising, prospective sham-controlled trials are urgently needed to confirm its efficacy and identify the patient populations who will benefit most from this procedure.Show less >
Language :
Anglais
Peer reviewed article :
Oui
Audience :
Internationale
Popular science :
Non
Source :