Gastric peroral endoscopic myotomy versus surgical pyloromyotomy/pyloroplasty for refractory gastroparesis: systematic review and meta-analysis

Autor: Muhammad Aziz, Manesh Kumar Gangwani, Hossein Haghbin, Dushyant Singh Dahiya, Amir Humza Sohail, Faisal Kamal, Wade Lee-Smith, Douglas G. Adler
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Endoscopy International Open, Vol 11, Iss 04, Pp E322-E329 (2023)
Druh dokumentu: article
ISSN: 2364-3722
2196-9736
DOI: 10.1055/a-1980-9942
Popis: Background and study aims Gastric per-oral endoscopic myotomy (G-POEM) has been recently compared with surgical techniques (i. e. pyloromyotomy and pyloroplasty) for managing patients with refractory gastroparesis. Given the varying results, we performed a systematic review and meta-analysis of available studies to assess the safety and efficacy of each technique. Patients and methods A comprehensive review of the literature using the following databases was undertaken through July 29, 2022: MEDLINE, Embase, Web of Science, KCI – Koran Journal index, Global Index Medicus, and Cochrane. Comparative studies including case-control, cohort and randomized controlled trials (RCTs) were included. Random effects model using DerSimonian laird approach was used to compare outcomes. Relative risk (RR) and mean difference (MD) were calculated for binary and continuous outcomes respectively. Results A total of four studies with 385 patients (216 in the G-POEM group and 169 in the surgical group were included. The mean age was 46.9 (± 3.41) and 46.2 (± 0.86) and the female proportion was 79.6 % and 74.0 % for the G-POEM and surgery group respectively. The mean procedural time (MD: –59.47 mins, P
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