{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:22:16Z","timestamp":1792790536947,"version":"4.5.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Pyloroplasty and gastric peroral endoscopic myotomy (G-POEM) are effective surgeries for gastroparesis. The primary aim of this study was to evaluate outcomes of pyloroplasty and G-POEM in patients with gastroparesis and determine factors associated with favorable outcome. The secondary aim was to assess the utility of clinical response to preoperative pyloric dilation or botulinum toxin injection (Botox) on surgical outcome, a factor conventionally used as a favorable marker.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>There were 204 patients who underwent pyloroplasty (<jats:italic>n<\/jats:italic>\u2009=\u2009177) or G-POEM (<jats:italic>n<\/jats:italic>\u2009=\u200927) for gastroparesis at our institution from 2014 to 2021. Demographic and clinical parameters were analyzed to assess their impact on surgical outcome. A subgroup of patients who had pyloric dilation or Botox injection were assessed separately. Favorable outcome was defined as patient reported complete resolution of the predominant gastroparesis symptom.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Favorable outcome was achieved in 78.4% of patients (pyloroplasty: 79.7% and G-POEM: 70.4%, <jats:italic>p<\/jats:italic>\u2009=\u20090.274). Among 61 patients where pre- and postoperative gastric emptying studies (GES) were available, mean 4-hour retention significantly improved from 33.5 to 15.0% (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and 77.0% of patients achieved normalization.<\/jats:p>\n                <jats:p>Favorable outcome was not significantly impacted by etiology of gastroparesis (<jats:italic>p<\/jats:italic>\u2009=\u20090.120), GERD (<jats:italic>p<\/jats:italic>\u2009=\u20090.518), or primary gastroparesis symptom (<jats:italic>p<\/jats:italic>\u2009=\u20090.244). Age\u2009\u2265\u200940 was a significant predictor of favorable surgical outcome on multivariate analysis [OR: 2.476 (1.224\u20135.008), <jats:italic>p<\/jats:italic>\u2009=\u20090.012]. Among the patients who had preoperative dilation (<jats:italic>n<\/jats:italic>\u2009=\u200982) or Botox injection (<jats:italic>n<\/jats:italic>\u2009=\u200946), response to these interventions was not a predictor of favorable surgical outcome (<jats:italic>p<\/jats:italic>\u2009=\u20090.192 and 0.979, respectively). However, preoperative Botox injection, regardless of response to injection, was associated with favorable surgical outcome [OR: 3.205 (CI 1.105\u20139.299), <jats:italic>p<\/jats:italic>\u2009=\u20090.032].<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Symptomatic improvement after pyloroplasty or G-POEM is independent of etiology of gastroparesis, GERD, and primary symptom. Response to dilation or Botox are not markers of response to surgery. However, patients who receive Botox are 3.2 times more likely to improve postoperatively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00464-023-09882-2","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T19:18:25Z","timestamp":1675797505000},"page":"4360-4369","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Predictors of favorable outcome after pyloroplasty for gastroparesis: should response to pyloric dilation or Botox injection be used as a marker of surgical outcome?"],"prefix":"10.1007","volume":"37","author":[{"given":"Sven E.","family":"Eriksson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Morton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Maurer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshitaka","family":"Hoppo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blair A.","family":"Jobe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8113-9164","authenticated-orcid":false,"given":"Shahin","family":"Ayazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"key":"9882_CR1","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1177\/0003134820952820","volume":"87","author":"BP Lovasik","year":"2021","unstructured":"Lovasik BP, Dodson TF, Srinivasan JK (2021) Heineke, Mikulicz, Jaboulay, and Finney: innovators of surgical pyloroplasty. 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Shahin Ayazi and Blair Jobe are on the scientific advisory board of Johnson and Johnson and receive consulting fee. Drs. Sven Eriksson, Ping Zheng, Scott Morton, Toshitaka Hoppo, and Ms. Nicole Maurer have no conflicts of interest or financial disclosures.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}