Safety and feasibility of same day discharge after per oral endoscopic pyloromyotomy in refractory gastroparesis: a pilot study  

作　　者：Rushikesh Shah Huimin Chen Lucie F.Calderon Tonia Gooden Maryam Mubashir Shazia Rashid Syed Musa Raza Allison Derise Grace Mccurdy Brenna Sanders Steve Keilin Qiang Cai 

机构地区：[1]Division of Digestive Diseases,Emory University School of Medicine,Atlanta,GA,USA [2]Division of Gastroenterology and Hepatology,Shanghai nsitute of Digestive Disease,Renj Hospital,Shanghai JjaoTong University School of Medicine,Shanghai 200127,China [3]Division of Gastroenterology and Hepatology,Louisiana State Universit,Shreveport,LA,USA

出　　处：《Chinese Medical Journal》2022年第12期1432-1437,共6页中华医学杂志（英文版）

摘　　要：Background:Gastroparesis is a debilitating medical condition with limited treatment options.Gastric per-oral pyloromyotomy(G-POEM)has emerged as a promising treatment option with remarkable short-term clinical success shown in multiple studies.While the post-procedure protocol is not standardized across many centers,the majority of the centers observes these patients in the hospital after the procedure for monitoring.In this single-center prospective study,we evaluated the safety and feasibility of same day discharge after the G-POEM procedure.Methods:All the patients with refractory gastroparesis undergoing G-POEM from October 2019 to March 2020 were enrolled.A total of 25 patients were enrolled in the procedure.Based on the pre-defined criteria,patients were either discharged on the same day after the procedure or admitted to the hospital for further observation.The patient and procedure-related data were extracted from the chart review.Univariate analysis was performed(chi-squared test)on categorical variables after organizing categorical variables as numeric counts or percentages.The student t test was performed on continuous variables after reporting as mean and standard deviation.For analysis with a smaller sample size,Fisher exact and Mann–Whitney tests were used.Results:A total of 25 patients were enrolled.The technical success of G-POEM was 100%and clinical success was 80%(20/25)at 1-month follow-up.Of the 25 patients,9 patients(36%)were discharged on the same day according to the procedure from the recovery unit.Of the remaining 16 patients who were admitted to the hospital post-procedure,10(40%)were admitted due to procedure-related causes while other admissions were either pre-planned or due to social reasons.The average Charlson comorbidity index was lower in the same day discharge group(P<0.05).The number of patients requiring double myotomy was higher in the same day discharge group(P<0.05).The overall complication rate of G-POEM in the study cohort was 12%(3/25)with all complications being mild

关 键 词：G-POEM PYLOROMYOTOMY GASTROPARESIS Gastric per-oral pyloromyotomy 

分 类 号：R573[医药卫生—消化系统]