Daniel Eckhardt and Moustafa Elshafei*
Department of General, Visceral and Thoracal Surgery, University Hospital Nuremberg, Paracelsus Medical University, GermanyFulltext PDF
Introduction: Gastroparesis is a chronic functional disorder including nausea, vomiting, bloating, abdominal pain, early satiety and postprandial fullness [1–4]. Several treatments have been reported, e.g. G-POEM, gastric electrical stimulation or pyloroplasty. There exist some metaanalysis of one of these treatments each, yet they do not compare all of them [5,6]. Methods: We extracted data from studies on intrapyloric Botox injection, G-POEM and gastric electric stimulation and calculated significance of mean differences according to Random-effects- Model including DerSimonian-Laird test (p<0.05). Results: Nutrition, pharmacotherapy and surgical treatments couldn`t be analyzed due to missing data or minor quality of data. We stated a significant reduction of 4.9 ± 0.48 in total GCSI in pre/ post Botox injection comparison, so did G-POEM`s mean GCSI (1.651 ± 0.144). 4 h -scintigraphies of G-POEM participants illustrated a significant decrease in gastric emptying scintigraphy (26.932% ± 2.442%). The most impressive effect occurred after implantation of a gastric electric stimulator: TSS scores decreased significantly in short and long term, as well as by comparing ON and OFF mode. Discussion: Comparing all these therapies, gastric electric stimulation seems to be the most successful option according to our findings. Our recommendation is, due to heterogeneity of data, moderate . G-POEM and intrapyloric Botox injections are evidence based treatments according to our and others' findings . Further studies, especially on the impact of combined therapies as well as on step up approaches are necessary.
Eckhardt D, Elshafei M. What to do with Gastroparetic Patients? A Systematic Review of Treatment Options. Clin Surg. 2022; 7: 3540..