ArticleiGIE : innovation, investigation and insights2026
Gastric peroral endoscopic pyloromyotomy as an effective treatment for symptomatic delayed gastric emptying after Ivor Lewis esophagectomy.
Article in iGIE : innovation, investigation and insights, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
11 authors.
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Abstract
Background and Aims: Delayed gastric emptying (DGE) is a frequent adverse event after Ivor Lewis esophagectomy, negatively affecting quality of life. Although gastric peroral endoscopic pyloromyotomy (G-POEM) is effective for gastroparesis, its role in postesophagectomy DGE remains uncertain. This study evaluates the feasibility and outcomes of G-POEM in this setting. Methods: We conducted a single-center retrospective analysis of 11 patients who underwent G-POEM after Ivor Lewis esophagectomy, all of whom had symptomatic DGE confirmed by gastric-emptying studies and Gastroparesis Cardinal Symptom Index scores. Results: All patients had confirmed DGE, with a median 49% (interquartile range, 24-80) gastric retention at 4 hours on gastric-emptying studies (normal is ≤10% retention at 4 hours). After G-POEM, gastric emptying normalized in 50% of patients and improved in 37.5%, with a median retention of 13% (0-75) at 4 hours. The median Gastroparesis Cardinal Symptom Index score improved from 25 (11-33) to 11 (2-33), where a score of 0 indicates no symptoms. Prokinetic use declined from 45.5% to 9.1%. The median procedure time was 68 (33-110) minutes, hospital stay was 1 (1-5) day, and no immediate adverse events were reported. Conclusions: G-POEM appears to be a feasible and safe treatment for DGE after Ivor Lewis esophagectomy, associated with early symptomatic improvement and minimal hospital stay although further prospective studies are needed.
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