Benias Petros C, Khashab Mouen A
Division of Gastroenterology, Hofstra Northwell School of Medicine, Northwell Health System, 300 Community Drive, Manhasset, NY, 11030, USA.
Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Sheikh Zayed Bldg, 1800 Orleans Street, Suite 7125G, Baltimore, MD, 21287, USA.
Curr Treat Options Gastroenterol. 2017 Dec;15(4):637-647. doi: 10.1007/s11938-017-0156-9.
Purpose of review Gastroparesis is a complex dysmotility disorder in which a number of normal gastric emptying mechanisms can be affected. The pylorus as an apparatus is particularly important since it stands as the last final gateway for gastric emptying. As such, pyloric interventions seem to be successful in reducing symptoms and also improving emptying of solids, an effect not observed with other medical interventions. Recent findings Gastric peroral endoscopic myotomy (G-POEM) is a novel technique which offers the promise of mimicking the success of a traditional surgical pyloroplasty, while embracing the minimally invasive paradigm of flexible endoscopic surgery. Emerging data seems to suggest that not only does G-POEM offer symptomatic and clinical improvement but also objective improvement in follow-up gastric emptying studies in as much as 70% of patients. Summary We believe that with proper patient selection, G-POEM will become a powerful tool for gastroenterologists managing this chronic debilitating disease.
综述目的 胃轻瘫是一种复杂的动力障碍性疾病，多种正常的胃排空机制可能受到影响。幽门作为一个器官尤为重要，因为它是胃排空的最后一道关卡。因此，幽门干预似乎能成功减轻症状并改善固体食物排空，这是其他药物干预所未观察到的效果。最新发现 经口内镜下胃肌切开术（G-POEM）是一种新技术，有望模仿传统手术幽门成形术的成功，同时秉持柔性内镜手术的微创模式。新出现的数据似乎表明，G-POEM不仅能改善症状和临床状况，而且在多达70%的患者中，后续的胃排空研究显示其能实现客观改善。总结 我们认为，通过合理选择患者，G-POEM将成为胃肠病学家治疗这种慢性衰弱性疾病的有力工具。
