Endoscopic pyloromyotomy for treatment of gastroparesis: A new standard or still an experimental approach?
Jazyk angličtina Země Nizozemsko Médium print-electronic
Typ dokumentu časopisecké články, přehledy
PubMed
39209413
DOI
10.1016/j.bpg.2024.101910
PII: S1521-6918(24)00032-5
Knihovny.cz E-zdroje
- Klíčová slova
- Endoflip, G-POEM, Gastroparesis, Pylorospasm,
- MeSH
- gastroparéza * chirurgie patofyziologie terapie etiologie MeSH
- lidé MeSH
- pyloromyotomie * metody škodlivé účinky MeSH
- pylorus * chirurgie patofyziologie MeSH
- recidiva MeSH
- výběr pacientů MeSH
- vyprazdňování žaludku MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Gastroparesis (GP) can be a severe and debilitating disease. Its pathophysiology is complex and not completely understood. Two principal mechanisms are responsible for the development of symptoms - gastric hypomotility and pylorospasm. Pylorus targeted therapies aim to decrease presumably elevated pyloric tone - pylorospasm. There is a growing body of evidence about their role in the treatment algorithm of GP. G-POEM (endoscopic pyloromyotomy) is an extensively studied pylorus targeted therapy. Its efficacy ranges between 56 and 80% and the number of recurrences among those with treatment effect seems low. G-POEM is a safe procedure with very low frequency of severe adverse events. At present, G-POEM should not be considered as an experimental approach and may be offered to all patients with refractory and severe GP. Nevertheless, G-POEM is not a first line treatment. Conservative measures such as diet modification and pharmacotherapy should always be tried before G-POEM is considered. Further research must focus on better patient selection as at present there are no standardized criteria. Functional imaging such as impedance planimetry (EndoFlip) may hold promise in this regard.
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