Gastric Per-Oral Endoscopy Myotomy (G-POEM): Tips, Tricks, and Pitfalls.

Q1 Medicine Current Gastroenterology Reports Pub Date : 2025-12-01 Epub Date: 2024-11-06 DOI:10.1007/s11894-024-00952-6

Grace E Kim, Mahnoor Khan, Sunil Amin, Amrita Sethi

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Abstract

Purpose of review: The number of hospitalizations for gastroparesis has risen over 300% in recent decades with increased physical, psychological, and healthcare burdens. Gastric per-oral endoscopic myotomy (G-POEM) is a promising therapy for patients with refractory gastroparesis. This article reviews important considerations for G-POEM.

Recent findings: Predictive factors for clinical success after G-POEM include diabetic and idiopathic gastroparesis, shorter gastroparesis duration, symptoms predominant of nausea and emesis, and gastric emptying study showing gastric retention of > 20% at 4 h. Mucosal closure is a critical step for G-POEM; both sutures and clips have high success rates, with clips having a trend to lower success rates but with significantly shorter procedure time and cheaper cost. G-POEMs have an overall 61% pooled success rate at one year with a yearly 13% symptom recurrence rate. A careful patient selection can yield higher clinical success rates. Further studies are needed on variant G-POEM techniques for more durable outcomes.

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胃经口腔内窥镜肌切开术（G-POEM）：诀窍、技巧和陷阱。

审查目的：近几十年来，因胃瘫住院的人数增加了 300% 以上，身体、心理和医疗负担也随之加重。胃经口内镜肌切开术（G-POEM）是一种治疗难治性胃瘫患者的有效方法。本文回顾了 G-POEM 的重要注意事项：G-POEM临床成功的预测因素包括糖尿病和特发性胃瘫、较短的胃瘫持续时间、以恶心和呕吐为主的症状，以及胃排空研究显示4小时内胃潴留>20%。粘膜闭合是G-POEM的关键步骤；缝合和夹子的成功率都很高，夹子的成功率有降低的趋势，但手术时间明显缩短，费用也更低。G-POEM 一年的总成功率为 61%，每年的症状复发率为 13%。谨慎选择患者可获得更高的临床成功率。还需要进一步研究变异的 G-POEM 技术，以获得更持久的疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Gastroenterology Reports Medicine-Gastroenterology

CiteScore

7.80

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0.00%

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期刊介绍： As the field of gastroenterology and hepatology rapidly evolves, the wealth of published literature can be overwhelming. The aim of the journal is to help readers stay abreast of such advances by offering authoritative, systematic reviews by leading experts. We accomplish this aim by appointing Section Editors who invite international experts to contribute review articles that highlight recent developments and important papers published in the past year. Major topics in gastroenterology are covered, including pediatric gastroenterology, neuromuscular disorders, infections, nutrition, and inflammatory bowel disease. These reviews provide clear, insightful summaries of expert perspectives relevant to clinical practice. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.

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