胃经口内镜肌切开术（G-POEM）：技巧、窍门和陷阱。
Gastric Per-Oral Endoscopy Myotomy (G-POEM): Tips, Tricks, and Pitfalls.
机构信息
Center for Endoscopic Research and Therapeutics (CERT), University of Chicago Medicine, 5841 S. Maryland Ave. Room M410, Chicago, IL, 60637, USA.
Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai South Nassau, New York, USA.
出版信息
Curr Gastroenterol Rep. 2025 Dec;27(1):3. doi: 10.1007/s11894-024-00952-6. Epub 2024 Nov 6.
PURPOSE OF REVIEW
The number of hospitalizations for gastroparesis has risen over 300% in recent decades with increased physical, psychological, and healthcare burdens. Gastric per-oral endoscopic myotomy (G-POEM) is a promising therapy for patients with refractory gastroparesis. This article reviews important considerations for G-POEM.
RECENT FINDINGS
Predictive factors for clinical success after G-POEM include diabetic and idiopathic gastroparesis, shorter gastroparesis duration, symptoms predominant of nausea and emesis, and gastric emptying study showing gastric retention of > 20% at 4 h. Mucosal closure is a critical step for G-POEM; both sutures and clips have high success rates, with clips having a trend to lower success rates but with significantly shorter procedure time and cheaper cost. G-POEMs have an overall 61% pooled success rate at one year with a yearly 13% symptom recurrence rate. A careful patient selection can yield higher clinical success rates. Further studies are needed on variant G-POEM techniques for more durable outcomes.
目的综述
近几十年来，胃轻瘫的住院人数增加了 300%以上，给患者带来了身体、心理和医疗负担。胃经口内镜肌切开术（G-POEM）是治疗难治性胃轻瘫的一种很有前途的疗法。本文综述了 G-POEM 的重要注意事项。
最新发现
G-POEM 后临床成功的预测因素包括糖尿病性和特发性胃轻瘫、胃轻瘫持续时间较短、以恶心和呕吐为主的症状、胃排空研究显示 4 小时时胃潴留>20%。黏膜闭合是 G-POEM 的关键步骤；缝线和夹闭都有很高的成功率，夹闭的成功率有下降趋势，但手术时间更短，成本更低。G-POEM 在一年时的总体成功率为 61%，每年症状复发率为 13%。仔细选择患者可以获得更高的临床成功率。需要进一步研究不同的 G-POEM 技术以获得更持久的效果。
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