Introduction Gastroparesis is a chronic, poorly understood, debilitating dis- order of the stomach, which is characterized by delayed gastric emptying without evidence of mechanical obstruction. Symp- toms include nausea, vomiting, early satiety, and/or epigastric pain and can significantly affect a patient’s quality of life. There has been a reported increase of 150% in prevalence in recent years [1 – 3]. The most common causes of gastroparesis include diabetes, medication, viral infection, postsurgical, and idio- pathic [4, 5]. Gastric peroral endoscopic myotomy for the treatment of refractory gastroparesis: a multicenter international experience Authors Michel Kahaleh 1 , Jean-Michel Gonzalez 2 , Ming-ming Xu 3 , Iman Andalib 4 , Monica Gaidhane 1 , Amy Tyberg 1 , Monica Saumoy 4 , Alberto Jose Baptista Marchena 5 , Marc Barthet 2 Institutions 1 Rutgers Robert Wood Johnson, New Brunswick, New Jersey, USA 2 Aarhus University, Marseille, France 3 Gastroenterology, Southern California Permanente Medical Group, Los Angeles, California, USA 4 Weill Cornell Medical Center, New York, New York, United States 5 Hospital de Clínicas Caracas, San Bernardino, Venezuela submitted 19.6.2017 accepted after revision 23.2.2018 Bibliography DOI https://doi.org/10.1055/a-0596-7199 | Published online: 12.4.2018 | Endoscopy 2018; 50: 1053–1058 © Georg Thieme Verlag KG Stuttgart · New York ISSN 0013-726X Corresponding author Michel Kahaleh, MD, Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Robert Wood Johnson University Hospital, 1 RWJ Place, MEB 464, New Brunswick, NJ 08901, USA Fax: +1-732-235-5537 mkahaleh@gmail.com ABSTRACT Background Gastroparesis is a difficult-to-treat motility disorder with a poor response to medical therapy. Gastric peroral endoscopic pyloromyotomy (G-POEM) has been of- fered as a novel therapy in the treatment of refractory gas- troparesis. We present a multicenter case series of our ex- perience with G-POEM. Methods This is an international multicenter case series of patients who underwent G-POEM for the treatment of gas- troparesis. The severity of gastroparesis was assessed by delayed gastric emptying scintigraphy (GES) and an elevat- ed gastroparesis cardinal symptoms index (GCSI). Patients then underwent G-POEM using the submucosal tunneling technique. The primary endpoint was improvement in the GCSI score and improvement in gastric emptying on repeat scintigraphy. Secondary endpoints were technical success, complication rate, procedure duration, and length of hospi- tal stay post-procedure. Results G-POEM was technically successful in all 33 pa- tients. Symptomatic improvement was seen in 28/33 pa- tients (85%), with a decrease in symptom score by GCSI from 3.3 to 0.8 at follow-up (P <0.001). The mean proce- dure duration was 77.6 minutes (37 – 255 minutes). Mean GES improved significantly from 222.4 minutes to 143.16 minutes (P< 0.001). Complications were minimal and in- cluded bleeding (n= 1) and an ulcer (n = 1) treated conser- vatively. The mean length of hospital stay post-procedure was 5.4 days (1 – 14 days). The mean follow-up duration was 11.5 months (2 – 31 months). Conclusion G-POEM is a technically feasible, safe, and suc- cessful procedure for the treatment of refractory gastropar- esis. A further multicenter comparative study should be performed to compare this technique to laparoscopic py- loromyotomy. Original article Scan this QR-Code for the authorʼ s interview. Kahaleh Michel et al. Gastric peroral endoscopic … Endoscopy 2018; 50: 1053–1058 1053 This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.