P2754 - Multicenter Study of Safety and Efficacy of Inpatient Gastric Peroral Endoscopic Myotomy (G-POEM) for Treatment of Refractory Gastroparesis

Lucia Soca Gallego, DO, Mahnur Haider, MD, Juliana Yang, MD
University of Texas Medical Branch, Galveston, TX

Introduction: Refractory gastroparesis is often associated with poor quality of life and high healthcare costs, partly due to care fragmentation, recurrent hospitalizations, and significant readmission rates.

Gastric Peroral Endoscopic Myotomy (G-POEM) is a successful technique used to treat refractory gastroparesis, typically as an elective, outpatient procedure. However, patients with gastroparesis frequently face challenges with outpatient follow-up. Therefore, performing G-POEM while admitted for gastroparesis can ensure delivery of necessary care and reduce hospitalizations. This study demonstrates the safety, efficacy, and feasibility of inpatient G-POEM in patients who previously faced challenges with outpatient follow-up for gastroparesis.

Methods: Medical records were analyzed to obtain clinical characteristics and procedural data of adults who underwent inpatient G-POEM for gastroparesis treatment. The primary outcome was clinical success after G-POEM, defined as one score decrease in the Gastroparesis Cardinal Symptom Index (GCSI) with ≥ 25% decrease in at least 2 of its sub-scales. GCSI was assessed at baseline, 1-3 months, and 24-36 months. Other outcomes were complications, length of hospital stay (LOS), readmissions, and hospitalizations.

Results: Seven patients underwent inpatient G-POEM for gastroparesis. All patients had frequent hospitalizations and high healthcare utilization. Majority (71%) were women, mean age of 45 (27–76), and average symptom duration of 40 months (5–108 months). Average GCSI scores were 4.3±0.6 at baseline, 2.4±1.3 at 1–3 months, and 2.1±1.4 at 24-36 months. At follow-ups, 5/7 (71%) patients achieved the primary outcome. Technical success rate was 100%, median LOS of 1 day (1–3 days), with zero procedure-related complications. There was one emergency visit and no hospitalizations. Participants of inpatient G-POEM had overall decreased GSCI scores associated with symptomatic improvement, lower complications, and decreased hospitalizations. (Table).

Discussion: Our findings demonstrate that inpatient G-POEM is safe, effective, and feasible in terms of clinical response, reducing care fragmentation and hospitalizations. Patients had significant improvement in symptoms, shorter LOS, and reduced readmissions and hospitalizations. Future studies of cost-effectiveness may help incorporate inpatient G-POEM into practice to reduce healthcare costs and improve quality of care.


Disclosures:


Lucia Soca Gallego, DO, Mahnur Haider, MD, Juliana Yang, MD. P2754 - Multicenter Study of Safety and Efficacy of Inpatient Gastric Peroral Endoscopic Myotomy (G-POEM) for Treatment of Refractory Gastroparesis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.