Abstract
Given the initial enthusiasm for per-oral endoscopic myotomy (POEM), surgeons and endoscopists began to search for other applications for the technique. Gastroparesis is a motility disorder of the stomach which is often refractory to medical therapy. Other options for treatment include endoscopic options such as botox injection or transpyloric stenting, gastric electrical stimulation, and surgical therapy such as laparoscopic pyloroplasty. Recently, surgeons have begun to apply POEM inspired techniques to the pylorus in an attempt to perform a transluminal pyloromyotomy. Although early series are small and limited largely to case reports, the early data is encouraging for this nascent procedure.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Abbreviations
- GES:
-
Gastric emptying study
- GCSI:
-
Gastroparesis cardinal symptom index
- NSAIDs:
-
Nonsteroidal anti-inflammatory drugs
- PAGI-SYM:
-
Patient assessment of upper gastrointestinal disorders–symptom severity index
- POEM:
-
Per-oral endoscopic myotomy
- POP:
-
Per-oral pyloromyotomy
- PPI:
-
Proton pump inhibitor
- PSG:
-
Postsurgical gastroparesis
- WMC:
-
Wireless motility capsules
References
Camilleri M, Parkman HP, Shafi MA, Abell TL, Gerson L. Clinical Guideline: Management of Gastroparesis. Am J Gastroenterol. 2013;108(1):18–37.
Pasricha PJ, Parkman HP. Gastroparesis: definitions and diagnosis. Gastroenterol Clin North Am. 2015;44(1):1–7.
Khoo J, Rayner CK, Jones KL, Horowitz M. Pathophysiology and management of gastroparesis. Expert Rev Gastroenterol Hepatol. 2009;3(2):167–81.
Revicki DA, Rentz AM, Dubois D, et al. Gastroparesis cardinal symptom index (GCSI): development and validation of a patient reported assessment of severity of gastroparesis symptoms. Qual Life Res. 2004;13(4):833–44.
Jung H-K, Choung RS, Locke GR, et al. The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006. Gastroenterology. 2009;136(4):1225–33.
Soykan I, Sivri B, Sarosiek I. Demography, clinical characteristics, psychological and abuse profiles, treatment, and long-term follow-up of patients with gastroparesis. Dig Dis Sci. 1998;43(11):2398–404.
Camilleri M, Bharucha AE, Farrugia G. Epidemiology, mechanisms, and management of diabetic gastroparesis. Clin Gastroenterol Hepatol. 2011;9(1):5–12.
Hyett B, Martinez FJ, Gill BM, et al. Delayed radionucleotide gastric emptying studies predict morbidity in diabetics with symptoms of gastroparesis. Gastroenterology. 2009;137(2):445–52.
Fich A, Neri M, Camilleri M, Kelly KA, Phillips SF. Stasis syndromes following gastric surgery: clinical and motility features of 60 symptomatic patients. J Clin Gastroenterol. 1990;12(5):505–12.
Parkman HP, Hasler WL, Fisher RS. American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis. Gastroenterology. 2004;127(5):1592–622.
Oh JH, Pasricha PJ. Recent advances in the pathophysiology and treatment of gastroparesis. J Neurogastroenterol Motil. 2013;19(1):18–24.
Fraser R, Horowitz M, Dent J. Hyperglycaemia stimulates pyloric motility in normal subjects. Gut. 1991;32(5):475–8.
Langworthy J, Parkman HP, Schey R. Emerging strategies for the treatment of gastroparesis. Expert Rev Gastroenterol Hepatol. 2016.
Tougas G, Eaker EY, Abell TL, et al. Assessment of gastric emptying using a low fat meal: establishment of international control values. Am J Gastroenterol. 2000;95(6):1456–62.
Viramontes BE, Kim DY, Camilleri M, et al. Validation of a stable isotope gastric emptying test for normal, accelerated or delayed gastric emptying. Neurogastroenterol Motil. 2001;13(6):567–74.
Kuo B, McCallum RW, Koch KL, Sitrin MD, Wo JM, et al. Comparison of gastric emptying of a nondigestible capsule to a radio-labelled meal in healthy and gastroparetic subjects. Aliment Pharmacol Ther. 2008;27(2):186–96.
Camilleri M, Hasler WL, Parkman HP, Quigley EMM, Soffer E. Measurement of gastrointestinal motility in the GI laboratory. Gastroenterology. 1998;115(3):747–62.
Bharadwaj S, Meka K, Tandon P, Rathur A, Rivas JM, Vallabh H, Jevenn A, Guirguis J, Sunesara I, Nischnick A, Ukleja A. The management of gastroparesis associated malnutrition. J Dig Dis. 2016 Apr 25 (Epub ahead of print).
Parkman HP, Yates KP, Hasler WL, et al. Dietary intake and nutritional deficiencies in patients with diabetic or idiopathic gastroparesis. Gastroenterology. 2011;141(2):486–98.
Camilleri M. Novel diet, drugs, and gastric interventions for gastroparesis. Clin Gastroenterol Hepatol. 2016;(February):1–10.
Ukleja A, Tandon K, Shah K, Alvarez A. Endoscopic botox injections in therapy of refractory gastroparesis. World J Gastrointest Endosc. 2015;7(8):790–8.
Heckert J, Sankineni A, Hughes WB, Harbison S, Parkman H. Gastric electric stimulation for refractory gastroparesis: a prospective analysis of 151 patients at a single center. Dig Dis Sci. 2016;61(1):168–75.
Mancini SA, Angelo JL, Peckler Z, Philp FH, Farah KF. Pyloroplasty for refractory gastroparesis. Am Surg. 2015;81(7):738–46.
Toro JP, Lytle NW, Patel AD, et al. Efficacy of laparoscopic pyloroplasty for the treatment of gastroparesis. J Am Coll Surg. 2014;218(4):652–60.
Jones MP, Maganti K. Clinical reviews a systematic review of surgical therapy for gastroparesis. 2003;98(10).
Speicher JE, Thirlby RC, Burggraaf J, Kelly C, Levasseur S. Results of completion gastrectomies in 44 patients with postsurgical gastric atony. J Gastrointest Surg. 2009;13(5):874–80.
Pasricha PJ, Hawari R, Ahmed I, Chen J, Cotton PB, et al. Submucosal endoscopic esophageal myotomy: a novel experimental approach for the treatment of achalasia. Endoscopy. 2007;39(9):761–4.
Inoue H, Minami H, Kobayashi Y, Sato Y, Kaga M, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy. 2010;42(4):265–71.
Kawai M, Perretta S, Burckhardt O, Dallemagne B, Marescaux J, Tanigawa N. Endoscopic pyloromyotomy: a new concept of minimally invasive surgery for pyloric stenosis. Endoscopy. 2012;44(2):169–73.
Khashab MA, Stein E, Clarke JO, Saxena P, Kumbhari V, et al. Gastric peroral endoscopic myotomy for refractory gastroparesis: first human endoscopic pyloromyotomy (with video). Gastrointest Endosc. 2013;78(5):764–8.
Shlomowitz E, Pescarus R, Cassera MA, Sharata AM, Reavis KM, et al. Early human experience with per-oral endoscopic pyloromyotomy (POP). Surg Endosc. 2015;29(3):543–51.
Khashab MA, Ngamruengphong S, Carr-Locke D, Bapaye A, Benais PC, et al. Gastric peroral endoscopic myotomy for refractory gastroparesis: results from the first multicenter study on endoscopic pyloromyotomy (with video). Gastrointest Endosc. 2016 Jun 25 (Epub ahead of print).
Kurian AA, Dunst CM, Sharata A, Bhayani NH, REavis KM, et al. Peroral endoscopic esophageal myotomy: defining the learning curve. Gastrointest Endosc. 2013;77(5):719–25.
Patel KS, Calixte R, Modayil RJ, Friedel D, Brathwaite CE, et al. The light at the end of the tunnel: a single-operator learning curve analysis for per oral endoscopic myotomy. Gastrointest Endosc. 2015;81(5):1181–7.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Shlomovitz, E., Prabhu, K.L., Reavis, K.M. (2017). Per-oral Endoscopic Pyloromyotomy. In: Romanelli, J., Desilets, D., Earle, D. (eds) NOTES and Endoluminal Surgery. Clinical Gastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-319-50610-4_9
Download citation
DOI: https://doi.org/10.1007/978-3-319-50610-4_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-50608-1
Online ISBN: 978-3-319-50610-4
eBook Packages: MedicineMedicine (R0)