Technical Aspects of Peroral Endoscopic Pyloromyotomy - 04/11/18

Doi : 10.1016/j.giec.2018.08.012

Jie Tao, MD ^a,^b, Vaishali Patel, MD, MHS ^a, Parit Mekaroonkamol, MD ^a, Hui Luo, MD ^a,^c, Baiwen Li, MD, PhD ^a,^d, Qunye Guan, MD, PhD ^a,^e, Shanshan Shen, MD, PhD ^a,^f, Huimin Chen, MD, PhD ^a,^g, Qiang Cai, MD, PhD ^a,^h,^⁎
^a Division of Digestive Disease, Emory University School of Medicine, 1365 Clifton RD NE, Suite B 1262, Atlanta, GA 30322, USA
^b Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 227 Yanta West Road, Xi'an 710061, China
^c Department of Pancreatobiliary Disease, Xijing Hospital of Digestive Disease, Fourth Military Medical University, 169 Changle West Road, Xi'an 710032, China
^d Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiaotong University, 100 Haining Road, Shanghai 200080, China
^e Department of Gastroenterology, Weihai Municipal Hospital, 70 Heping Road, Weihai 264200, China
^f Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing 210008, China
^g Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 145 Shandongzhong Road, Shanghai 200240, China
^h Advanced Endoscopy Fellowship, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322, USA

^∗Corresponding author. Advanced Endoscopy Fellowship, Emory University School of Medicine, 1365 Clifton Road, B1262, Atlanta, GA 30322.Advanced Endoscopy FellowshipEmory University School of Medicine1365 Clifton RoadB1262AtlantaGA30322

Résumé

Gastric peroral endoscopic pyloromyotomy (G-POEM or POP) is a feasible and effective procedure for the treatment of refractory gastroparesis. G-POEM is a technically demanding endoscopic procedure. As of yet, there is no consensus on the technique. A variety of techniques have been reported in published studies. The essential technical steps of the procedure are (1) establishment of submucosal tunnel in gastric antrum, (2) identification of the pyloric muscular ring, (3) selective circular myotomy, and (4) a 2.5-cm to 3.0-cm length of myotomy. There are still some technical questions unanswered, and more studies are needed to establish standardized techniques and possible improvement of outcomes.

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Keywords : G-POEM, Refractory gastroparesis, Technical aspects, POP

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Introduction

The gastric peroral endoscopic pyloromyotomy

Patient selection

Gastric peroral endoscopic pyloromyotomy procedure

Post gastric peroral endoscopic pyloromyotomy treatment

Discussions of technical aspects

Summary

Disclosures: The authors have nothing to disclose.

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Vol 29 - N° 1

P. 117-126 - janvier 2019 Retour au numéro

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