TY - JOUR T1 - Gastric emptying study before gastric peroral endoscopic myotomy (G-POEM): can intragastric meal distribution be a predictor of success? JF - Gut JO - Gut DO - 10.1136/gutjnl-2022-327701 SP - gutjnl-2022-327701 AU - Francesco Vito Mandarino AU - Sabrina Gloria Giulia Testoni AU - Alberto Barchi AU - Gino Pepe AU - Dario Esposito AU - Lorella Fanti AU - Edi Viale AU - Paolo Biamonte AU - Francesco Azzolini AU - Silvio Danese Y1 - 2022/06/13 UR - http://gut.bmj.com/content/early/2022/06/12/gutjnl-2022-327701.abstract N2 - We read with great interest the article by Vosoughi et al,1 describing outcomes of gastric peroral endoscopic myotomy (G-POEM), performed on 80 patients with refractory gastroparesis. Clinical and Gastric Emptying Study (GES) improvement achieved in 56% and 64.2% of patients, respectively, are meaningful, even though the need to find predictors of G-POEM success and to select optimal patients remains a pivotal issue.2Despite showing fairly better results, the largest studies in literature have not identified useful non-invasive parameters to foresee postprocedural success.3 4 Vosoughi et al found baseline Gastric Cardinal Symptom Index (GCSI) >2.6 and 4 hours per cent gastric retention (PGR) >20% as predictors of 12-month clinical response, defined as 1-score decrease in total GCSI with a decrease of 25% in at least two out of three symptomatic subscales.1Concerning invasive parameters predicting success, contrasting results have been provided by high pylorus distensibility, evaluated with preprocedural Functional Lumen Imaging Probe (FLIP) (EndoFlip V.2.0 Medtronic). While in a retrospective study of 37 patients, FLIP measurement was correlated with clinical improvement after G-POEM,5 in a recent prospective report by Gregor et al the distensibility index has not proved to be … ER -