Gastric Peroral Endoscopic Myotomy in Refractory Gastroparesis: A Narrative Review
Year: 2026
Type: review
Abstract: Gastroparesis is a chronic and frequently incapacitating disorder marked by delayed gastric emptying in the absence of mechanical obstruction, leading to symptoms such as nausea, vomiting, early satiety, and abdominal pain. Traditional medical treatments are often insufficient, resulting in considerable morbidity and healthcare strain. Gastric peroral endoscopic myotomy (G-POEM) has developed in the last decade as a minimally invasive endoscopic technique aimed at addressing pyloric dysfunction. This review consolidates existing evidence on the efficacy, safety, predictors of response, and developing frameworks for outcome classification following G-POEM. Data from prospective single-center cohorts indicate clinical success rates up to 48% at 12 months, along with enhancements in symptom scores, gastric emptying, and quality of life in suitably selected patients. G-POEM has a favorable safety profile, with adverse events occurring in approximately 4%-6% of cases, the majority of which are manageable endoscopically. Notable recent advances include an international classification scheme that categorizes G-POEM outcomes into four response phenotypes according to the concordance between symptomatic and physiologic (gastric emptying) improvement, together with multicenter evidence supporting the safety of same-day discharge in uncomplicated cases. Although promising, existing evidence is constrained by variability in patient selection and outcome definitions, and there is a deficiency of randomized controlled trials. G-POEM constitutes a significant enhancement to the therapeutic options for refractory gastroparesis, with continuous improvements in patient stratification and post-procedural management anticipated to maximize results.
Language: English
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7222566788