Constipation is Associated with Long-Term Clinical Failure After G-POEM for the Treatment of Gastroparesis: A Multivariate Retrospective Analysis of 80 Patients

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Aims This study investigates the role of constipation and other digestive motors disorders in predicting the long-term success of Gastric Peroral Endoscopic Myotomy (G-POEM) for treating gastroparesis. Methods This was a retrospective observational study. Patients who underwent G-POEM between July 2015 and August 2022 with>6 months follow-up were included. The primary objective was to evaluate the relationship between constipation and G-POEM success. Secondary objectives included documenting the role of other digestive motor disorders, history of eating disorders, chronic opioid use and cannabis use. Multivariate logistic regression analysis was used to evaluate the relationship between clinical success and various parameters, including constipation. Results 80 patients were included, 58 women (72.5%) and 22 men (27.5%) with a mean age of 51.78 years. The mean follow-up was 3.4 years. Clinical success was observed in 52.5% of the patients post-G-POEM. 42.5% had constipation, 17.7% had esophageal motor disorders (EMD) and 13.9% had other motor disorders. In univariate analysis, constipation and EMD were more frequent in patients with failure: 57.89% vs 28.57%, p=0.015 and 28.95% vs 7.32%,p=0.017, respectively. In multivariate analysis, the presence of constipation (OR=0.345 [0.121; 0.983], p=0.0463) was the only predictive factor for success. Conclusions Constipation emerged as a significant predictor of lower clinical success rates after G-POEM. It suggests that an expanded gastrointestinal evaluation for other motor disorders may improve the outcomes for patients with gastroparesis treated with G-POEM. Publication History Article published online: 15 April 2024 © 2024. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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