Transpyloric Stenting for Refractory Gastroparesis prior to Gastric Per-Oral Endoscopic Myotomy: A Multicenter Prospective Sham Study

Examining whether transpyloric stenting, a temporary endoscopic procedure which helps to improve how food in the stomach empties, can be used to predict future response to gastric per-oral endoscopic myotomy (G-POEM), a more permanent procedure that is currently being performed for treatment of delayed gastric emptying. Gastroparesis is defined as a complex syndrome of symptoms including early satiety, post-prandial fullness, nausea, vomiting, bloating, and upper abdominal pain. Recent data has shown a substantial increase of 158% in hospitalizations related to gastroparesis in recent years. ith advancements in endoscopic submucosal dissection (ESD), gastric per-oral endoscopic myotomy (G-POEM) has recently come in to light as a minimally invasive technique to treat refractory gastroparesis. A total of 38 patients with refractory gastroparesis will be enrolled in this multicenter, single-blinded, randomized sham-control prospective study. Preoperatively, assessments will include obtainment of a gastric emptying study as well as multiple standardized questionnaires. atients will be required to follow-up in clinic one month and then by phone or in clinic at 3 and 6 months, after G-POEM to evaluate for symptom response and any complications related to the procedure.