Chinese Medical Journal (Jun 2022)

Safety and feasibility of same day discharge after per oral endoscopic pyloromyotomy in refractory gastroparesis: a pilot study

  • Rushikesh Shah,
  • Huimin Chen,
  • Lucie F. Calderon,
  • Tonia Gooden,
  • Maryam Mubashir,
  • Shazia Rashid,
  • Syed Musa Raza,
  • Allison Derise,
  • Grace Mccurdy,
  • Brenna Sanders,
  • Steve Keilin,
  • Qiang Cai,
  • Yanjie Yin

DOI
https://doi.org/10.1097/CM9.0000000000002068
Journal volume & issue
Vol. 135, no. 12
pp. 1432 – 1437

Abstract

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Abstract. Background:. Gastroparesis is a debilitating medical condition with limited treatment options. Gastric per-oral pyloromyotomy (G-POEM) has emerged as a promising treatment option with remarkable short-term clinical success shown in multiple studies. While the post-procedure protocol is not standardized across many centers, the majority of the centers observes these patients in the hospital after the procedure for monitoring. In this single-center prospective study, we evaluated the safety and feasibility of same day discharge after the G-POEM procedure. Methods:. All the patients with refractory gastroparesis undergoing G-POEM from October 2019 to March 2020 were enrolled. A total of 25 patients were enrolled in the procedure. Based on the pre-defined criteria, patients were either discharged on the same day after the procedure or admitted to the hospital for further observation. The patient and procedure-related data were extracted from the chart review. Univariate analysis was performed (chi-squared test) on categorical variables after organizing categorical variables as numeric counts or percentages. The student t test was performed on continuous variables after reporting as mean and standard deviation. For analysis with a smaller sample size, Fisher exact and Mann–Whitney tests were used. Results:. A total of 25 patients were enrolled. The technical success of G-POEM was 100% and clinical success was 80% (20/25) at 1-month follow-up. Of the 25 patients, 9 patients (36%) were discharged on the same day according to the procedure from the recovery unit. Of the remaining 16 patients who were admitted to the hospital post-procedure, 10 (40%) were admitted due to procedure-related causes while other admissions were either pre-planned or due to social reasons. The average Charlson comorbidity index was lower in the same day discharge group (P 50% of patients with close periprocedural monitoring.