Same-Day Discharge, Medical and Non-Medical Admission After Per-Oral Endoscopic Pyloromyotomy

Abstract

Objectives

Gastric per-oral endoscopic myotomy (G-POEM) is a promising treatment for gastroparesis. Our previous pilot study has indicated that about 50% of patients could be safely discharged home on the same day as the procedure. In this study, we presented more data on this topic and divided admission into medical and non-medical admissions to assess the safety of same-day discharge after the G-POEM procedure.

Methods

All patients who underwent G-POEM for gastroparesis at our institution from April 2022 to June 2023 were included. After undergoing G-POEM, patients who met the following four criteria would be discharged on the same day: (i) no major complications during the procedure; (ii) patient having abdominal pain scored 4 or less on a pain scale from 0 to 10, or > 4 but improved after having one dose of intravenous pain medication; (iii) no vomiting after the procedure; and (iv) the patient had someone at home to help them access medical care when necessary. The admitted patients were divided into two groups: those with medical issues, and those with non-medical issues.

Results

Altogether 61 consecutive patients were included in this study, among whom 40 (65.6%) were discharged on the same day. Among the 21 (34.4%) patients who were admitted to the hospital for observation, 12 were admitted for non-medical issues. The remaining nine (14.8%) patients were admitted for medical issues.

Conclusions

After about 10 years of practice, G-POEM is a safe endoscopic therapeutic modality. This study shows that 85.2% of patients undergoing G-POEM can be discharged on the same day.