G-POEM IN REFRACTORY GASTROPARESIS, FOR WHOM? LONG TERM OUTCOMES AND PREDICTIVE SCORE TO IMPROVE PATIENT SELECTION

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Aims Limited data exist concerning the long-term efficiency of G-POEM as a treatment of refractory gastroparesis. This study evaluates the 3-year results of G-POEM in patients with refractory gastroparesis, then investigated predictive factors for procedure success or failure. Methods This was a prospective multicenter study of all G-POEM operations performed in two expert French centers for refractory gastroparesis with at least 3 years of follow-up (n=46). GCSI was recorded every 6 months during follow-up. Results Clinical success was 65.2% at 36 months. Median GCSI decreased from 3.33 to 1.80 (p<0.0001) with improvement in all subscales. We create a predictive score concerning G-POEM success or failure to which points were assigned as follows: Table 1 Criterion Score assigned Nausea subscale<2 +1 Satiety subscale>4 +1 Bloating subscale>3.5 +1 Retention at 4 hours on scintigraphy>50% +1 A threshold of 2 was identified by receiver operating characteristic curve analysis with an area under the curve of 0.825 that predicted clinical success with 93.3% sensitivity, 56.3% specificity, 80% PPV, 81.8% NPV and 80.4% accuracy. Patients with a score≥2 were significantly more likely to be responders at 3 years than were patients with a score<2 (80% and 18% respectively; p=0.0004). Conclusions The clinical success of G-POEM for refractory gastroparesis was 65.2% at 36 months. Our predictive score offers an easy tool that should be confirmed in other studies. Publication History Article published online: 14 April 2022 © 2022. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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