Efficacy and Safety of Gastric Peroral Endoscopic Myotomy (G-POEM) Performed by Early Career Endoscopists: A Multicenter Retrospective Study

Abstract

Background:

Gastric peroral endoscopic myotomy (G-POEM) is an effective, minimally invasive treatment for refractory gastroparesis. However, limited data exists on its performance by early-career endoscopists (1-3 years post-advanced endoscopy training). This multicenter study assessed the technical and clinical outcomes of G-POEM performed by early-career endoscopists, providing insight into their procedural efficacy and safety.

Methods:

This retrospective study analyzed patients who underwent G-POEM performed by early-career endoscopists across multiple US centers. Patient demographics, procedural characteristics, and follow-up data were collected. Primary outcomes included technical success and clinical response (defined as a ≥1-point improvement in the Gastroparesis Cardinal Symptom Index [GCSI]). Secondary outcomes included adverse events, hospital length of stay, and the need for reintervention.

Results:

A total of 103 patients (mean age 48.9 ± 15.2 years; 75.5% female) underwent G-POEM by seven early-career endoscopists. Gastroparesis etiologies included idiopathic (36.9%), diabetes (32%), and post-transplant (13.6%). Technical success was 100%, and clinical response was 73.8%, with comparable efficacy between severe-to-very-severe and mild-to-moderate cases (79% vs 69.2%; P = .26). 23.3% of patients were discharged in the same day as the procedure and the mean hospital stay was 1.22 ± 0.59 days. Adverse events were minimal, with no major complications. Nine patients (8.7%) required reintervention.

Conclusions:

G-POEM performed by early-career endoscopists is safe and effective, with high technical success and clinical response rates. Comparable efficacy was observed across gastroparesis severity levels. Larger studies are needed to further evaluate outcomes and guide training and practice.

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