Impact of Interstitial Cells of Cajal Density and Other Factors on Clinical Outcomes Following G-POEM in Gastroparesis Patients.

BACKGROUND

Gastroparesis remains an elusive disorder with debilitating symptoms. There has been some progress in treatment options, such as gastric per oral endoscopic pyloromyotomy (G-POEM). It is unknown whether the number of gastric interstitial cells of Cajal (ICC) is related to the outcome of G-POEM.

METHODS

All patients who underwent G-POEM and had gastric muscle biopsy at G-POEM were enrolled. A direct biopsy of the exposed antral smooth muscles was performed during G-POEM to quantify the ICC. The relationship between the outcome of G-POEM and the number of ICC was analyzed.

RESULTS

Eighty-four patients were included in this study. The average age was 48.5 years; 77.6% were females, 47.6% of the patients had diabetic gastroparesis, 16.7% had post-surgical gastroparesis, and 35.7% had idiopathic gastroparesis. All the patients had failed other therapy. 82.9% of the patients had no intra or immediate postoperative complications, and the average procedure time was 29 min. 70% of the patients were discharged the same day. The average hospital stay for the rest was 2.6 days. The average time to follow-up was 5 months. 100% of patients had technical success, and 57.4% of patients had clinical success. The average number of ICC/4 mm was 409.14. It was noted that that the number of ICCs is not a predictor of the success of G-POEM.

CONCLUSION

The association between the number of ICC and the clinical outcomes of G-POEM is not observed in this study. To our knowledge, this is the first such report. Further research on the pathogenesis of gastroparesis is needed.