SSAT - NOVEL MINIMALLY INVASIVE GASTRIC PER ORAL ENDOSCOPIC MYOTOMY FOR MANAGEMENT OF GASTROPARESIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Back to 2025 Abstracts

NOVEL MINIMALLY INVASIVE GASTRIC PER ORAL ENDOSCOPIC MYOTOMY FOR MANAGEMENT OF GASTROPARESIS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Shradha Chervittara Karaveetil¹, Anmol Rao¹, Ananya Prasad¹, Vinay Chandramouli Bellur^*¹, Aashray N. Alva¹, Deepika Reddy Aluru², Ankita Raj², Disha Prashanth¹, Adithya Sathya narayana¹, Shree Charan¹, Pavan Kumara Kasam Shiva², Advaith N. Rao¹, Sravani Bhavanam³
¹MS Ramaiah Medical College, Bangalore, Karnataka, India; ²Bangalore Medical College and Research Institute, Bangalore, KA, India; ³Brookdale University Hospital Medical Center, New York, NY

Introduction
Gastroparesis is a chronic digestive disorder with rising incidence currently, due to the surge in abdominal surgeries, viral infections, diabetes and autoimmune diseases. Conservatively, Gastroparesis is managed by dietary modifications and symptomatic management through prokinetic drugs and antiemetics, yet these result in short term resolution of symptoms and are limited by adverse effects. Gastric per oral endoscopic myotomy (G-POEM) is a novel surgical technique where pyloromyotomy is performed to reduce pylorospasm, leading to improvement in gastric emptying and overall symptom resolution. This study assesses the efficacy and safety of G-POEM in the management of gastroparesis, provide an analytical overview of the existing literature and highlight gaps for future research.

Methods
The review conducted follows the PRISMA guidelines and major medical databases which include PUBMED, Google Scholar and Science-Direct were extensively searched using a a comprehensive search term to identify and retrieve available articles. The articles in which per-oral endoscopic myotomy was performed for the treatment of Gastroparesis were considered in our study. The outcomes analysed included mean change in GSCI score pre and post-treatment, the mean duration of the procedure and the proportion of the population with clinical response of intention to treat. The data was analysed using the Meta, Metadata and the Metafor packages of R studio. The change in Mean difference before and after the procedure was evaluated using the Inverse variance method. The proportion of the population with a successful response of intention to treat was estimated using the Random intercept logistic regression model. The confidence interval was estimated by using the Clopper-Pearson method. The I^2 Test evaluated the heterogeneity of the studies.

Results
The meta-analysis involved a total of 24 studies with 733 subjects. The study observed a decrease in mean GSCI score post the intended treatment which was evaluated by pooled change in mean GSCI score( -5.19[2.40 - 7.97]; 95% CI ; p = 0 ) indicating a decrease in the severity of symptoms of gastroparesis. The pooled procedure time was estimated to be 50.99 minutes (50.99[40.29 - 61.70] ; 95% CI ; p<0.05). The proportion of the population who showed clinical response to intention to treat was estimated to be 0.94.(0.94 [0.83-0.98] ; 95% CI ; p=0.77)

Conclusion
Gastroparesis significantly alters the quality of life of the patients and conservative management does not provide long term relief . Our study highlights the outcomes following Per-Oral Myotomy procedure which shows significant reduction of GSCI score and a high value of clinical response to intention to treat .The results indicate that G-POEM is a promising intervention to treat gastroparesis although further clinical trials and studies are needed to prove the same.

Back to 2025 Abstracts