Published online Feb 28, 2019. doi: 10.3748/wjg.v25.i8.909
Peer-review started: November 1, 2018
First decision: November 29, 2018
Revised: January 10, 2019
Accepted: January 26, 2019
Article in press: January 26, 2019
Published online: February 28, 2019
Per oral endoscopic pyloromyotomy (POP), also known as gastric per-oral endoscopic myotomy (GPOEM), is a novel procedure with promising potential for the treatment of gastroparesis. As more data emerge and the procedure is becoming more recognized in clinical practice, its safety and efficacy need to be carefully evaluated. Appropriate patient selection for favorable clinical success prediction after GPOEM also needs additional research. This review aims to systemically summarize the existing data on clinical outcomes of POP. Symptomatologic responses to the procedure, its adverse effects, procedural techniques, and predictive factors of clinical success are also discussed.
Core tip: Per oral endoscopic pyloromyotomy (POP), or gastric per oral endoscopic myotomy is a viable therapeutic modality for patients with medically refractory gastroparesis. POP has demonstrated promising mid-term clinic outcomes in up to 18 mo follow-up period. However, most published studies were single-center and retrospective. Duration of the disease, prior response to intrapyloric botulinum injection, and increased pyloric cross-sectional area has been described as predictive factors for POP outcome. Impedance planimetry can be used to evaluate pyloric dysfunction. However, the reliability of these factors still needs clinical validation.