Journal article
CLINICAL RESPONSE TO GASTRIC PERORAL ENDOSCOPIC MYOTOMY AND ITS ASSOCIATION TO CHANGES IN PYLORIC IMPEDANCE PLANIMETRY MEASUREMENTS: A SYSTEMATIC REVIEW AND META ANALYSIS
Gastrointestinal endoscopy
01/16/2026
DOI: 10.1016/j.gie.2026.01.008
PMID: 41548721
Abstract
Gastric per-oral endoscopic myotomy (G-POEM) has emerged as a potential therapy for patients
with medically refractory gastroparesis. While adequate patient selection is crucial, there is a
paucity of data on factors that may help select patients and predict a favorable response to G-POEM.
We performed a systematic review and meta-analysis to evaluate pyloric functional luminal imaging probe (FLIP) changes in patients undergoing G-POEM. Pre- and post-G-POEM data were collected and analyzed. Clinical response was defined as an improvement of at least 1 point in the mean overall Gastroparesis Cardinal Symptom Index (GCSI) score, consistent with criteria used across included studies. Standardized mean differences (SMD) compared metrics between groups (responders vs non-responders), and pooled success rates with 95% confidence intervals (CI) were estimated with random-effects models, with heterogeneity assessed by I2.
Four studies involving 203 patients (76.7% women, mean age 55.2 years), were included in the final analysis. Overall pooled clinical success and failure rates were 70.3% (CI 63.5-76.3; I2 0%) and 31.3% (CI 25.3-38.3; I2 0%), respectively. There were no differences between the responders vs. non-responders in baseline pyloric FLIP measurements. We found a statistically significant increase in the distensibility index (DI) following G-POEM in both groups. Conversely, pylorus cross- sectional area (CSA) only improved significantly among responders, 183.1 mm2 (163.8-202.5) vs 146.9 mm2 (125.1-168.8); SMD -0.71 (-0.99 to -0.43); P<0.001; I2=0% but not in non-responders following G-POEM.
Our analysis shows that patients who responded to G-POEM had higher baseline GCSI scores when compared to non-responders. Post-G- POEM pylorus CSA was associated with clinical response. FLIP may provide objective assessment of pyloric changes and be a potential tool to predict clinical outcome of G-POEM. Additional studies with standardized FLIP protocols in patients undergoing G-POEM are needed.
Details
- Title: Subtitle
- CLINICAL RESPONSE TO GASTRIC PERORAL ENDOSCOPIC MYOTOMY AND ITS ASSOCIATION TO CHANGES IN PYLORIC IMPEDANCE PLANIMETRY MEASUREMENTS: A SYSTEMATIC REVIEW AND META ANALYSIS
- Creators
- Harsimran Kalsi - University of FloridaSaurabh Chandan - Houston MethodistJay Bapaye - Carilion ClinicBabu P. Mohan - Orlando Gastroenterology PA, Orlando, FL, USAAbdullah Abbasi - University of IowaSagar Pathak - Loma Linda UniversityErnesto Robalino Gonzaga - University of PennsylvaniaDeepanshu Jain - AdventHealth OrlandoNatalie D. Cosgrove - AdventHealth OrlandoKambiz S. Kadkhodayan - AdventHealth OrlandoMustafa A. Arain - AdventHealth OrlandoMuhammad K. Hasan - AdventHealth OrlandoMaham Hayat - AdventHealth OrlandoDennis Yang - AdventHealth Orlando
- Resource Type
- Journal article
- Publication Details
- Gastrointestinal endoscopy
- DOI
- 10.1016/j.gie.2026.01.008
- PMID
- 41548721
- NLM abbreviation
- Gastrointest Endosc
- ISSN
- 0016-5107
- eISSN
- 1097-6779
- Publisher
- Elsevier Inc
- Language
- English
- Electronic publication date
- 01/16/2026
- Academic Unit
- Internal Medicine
- Record Identifier
- 9985130237202771
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