G-POEM – Gastrale perorale endoskopische Myotomie als Therapieoption bei chronischer Magenentleerungsstörung

Zusammenfassung

Vor der chirurgischen Intervention einer Pyloromyotomie mittels Laparoskopie scheuen sich viele Ärzte und Patienten. Die Wirksamkeit von Botulinumtoxin-Injektionen in den Pylorus ist nicht nachgewiesen [1] [2]. Pharmakologische Therapieansätze sind unbefriedigend und zeigen vielfältige Nebenwirkungen [3]. G-POEM ist eine Prozedur, die ihre Machbarkeit bei niedriger Komplikationsrate belegen konnte. In den bisherigen Publikationen konnte ein relativ hohes Ansprechen dokumentiert werden [4]. Noch kontrovers werden die Langzeiterfolge diskutiert [5]. Nach anfänglicher Euphorie tritt immer mehr das Problem der Patientenselektion in den Vordergrund. Die Symptome ebenso wie die Pathophysiologie der Magenentleerungsstörung sind vielfältig [6]. Die zur Verfügung stehenden diagnostischen Tests spiegeln die Variabilität der Erkrankung nicht wider [7] [8] [9] [10]. Eine Ausnahme scheint hier die postoperative Magenentleerungsstörung darzustellen [11]. G-POEM kann sowohl Therapeuten als auch Patienten vor einem weiteren invasiven Eingriff schützen.

Abstract

Many doctors and patients shy away from the surgical intervention of a pyloromyotomy using laparoscopy. The effectiveness of botulinum toxin injections into the pylorus has not been established [1] [2]. Pharmacological therapeutic approaches are unsatisfactory and show a wide range of side effects [3]. G-POEM is a procedure that has proven its feasibility with a low complication rate. A relatively high response could be documented in previous publications [4]. The long-term successes are still being discussed controversially [5]. After the initial euphoria, the problem of patient selection comes to the fore. The symptoms, as well as the pathophysiology of gastric emptying disorder, are diverse [6]. The diagnostic tests available do not reflect the variability of the disease [7] [8] [9] [10]. The postoperative gastric emptying disorder seems to be an exception. G-POEM can protect both therapists and patients from another invasive procedure.

Schlüsselwörter

G-POEM - Gastroparese - Postoperative Gastroparese

Keywords

G-POEM - gastroparesis - postoperative gastroparesis

Publication History

Received: 03 July 2021

Accepted after revision: 17 October 2021

Article published online:
24 November 2021

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