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World J Gastroenterol. Feb 28, 2019; 25(8): 909-922
Published online Feb 28, 2019. doi: 10.3748/wjg.v25.i8.909
Outcomes of per oral endoscopic pyloromyotomy in gastroparesis worldwide
Parit Mekaroonkamol, Rushikesh Shah, Qiang Cai
Parit Mekaroonkamol, Rushikesh Shah, Qiang Cai, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA 30322, United States
Author contributions: All authors have contributed to this study.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Qiang Cai, MD, PhD, Professor, Division of Digestive Diseases, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, United States. qcai@emory.edu
Telephone: +1-4047782714 Fax: +1-4047782578
Received: October 30, 2018
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
Abstract

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.

Keywords: Gastroparesis, Per oral endoscopic pyloromyotomy, Gastric per-oral endoscopic myotomy, Pyloromyotomy, Outcomes

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.