Outcomes of Gastric Per-Oral Endoscopic Pyloromyotomy for Severe Gastroparesis in a Lung Transplant Patient Population

Abstract

Gastroparesis is a common and potentially devastating complication of lung transplantation. Initial results of Gastric Per-oral Endoscopic Pyloromyotomy (G-POEM) for the treatment of gastroparesis are encouraging but it's use in lung transplant is unknown. Retrospective cohort analysis of consecutive patients treated with G-POEM for medically refractory gastroparesis secondary to lung transplantation. Clinical, demographic, procedural and post procedural data was collected. 11 patient underwent G-POEM procedure. Technical and clinical success was noted in all 11 patients. Statistically significant decreases in gastroparesis symptom scores (GCSI) were noted in all 11 patients. In patients that obtained repeat GES, 100% experienced improvements in 4 hr GES emptying. Normalization of GES (<10% retention at 4 hrs) was noted in 3/7 patients. No significant difference in FEV1 or FVC was noted post G-POEM. 1 patient experienced accidental mucosotomy and 1 patient delayed pyloric stricture. All adverse events were managed endoscopically. G-POEM is a safe and efficacious treatment for medical refractory gastroparesis secondary to lung transplantation.