{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:30:19Z","timestamp":1777937419091,"version":"3.51.4"},"reference-count":9,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Gastroparesis is a progressive disease that may require endoscopic or surgical intervention, such as gastric per oral endoscopic myotomy (G-POEM), when conservative measures are ineffective or not tolerated. Limited data exist on redo G-POEM safety and effectiveness. We describe outcomes of patients undergoing repeat G-POEM for refractory gastroparesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review of patients who underwent redo G-POEM at our center from 2008 to 2024. Data included demographics, gastroparesis etiology, previous treatments, Gastroparesis Cardinal Symptom Index (GCSI), gastric emptying studies (GES), and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Three patients (mean age at first G-POEM 52.3 \u00b1 19 years) were identified. All procedures were technically successful, and all 3 patients survived to discharge without major complications. Patient A (sarcoidosis-induced gastroparesis) had transient symptomatic improvement after the first G-POEM, but symptoms deteriorated the following year. GES showed initial improvement (26% to 14% 4-hour retention) but returned to baseline (26%) after the second G-POEM. She ultimately required jejunostomy tube placement. Patient B (idiopathic gastroparesis) with a history of renal transplant showed no objective improvement in GES after either procedure (40% to 41% 4-hour retention) and remained noncompliant with dietary recommendations. He died at age 35 from cardiac arrhythmia 2 years after the second G-POEM. Patient C (postsurgical gastroparesis) had improvement in GES after the first G-POEM (88% to 53% 4-hour retention) but then deteriorated to 73% despite symptomatic improvement. After symptom recurrence, redo G-POEM provided an excellent symptomatic response, but she remained total parenteral nutrition-dependent until death 4 years later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>While redo G-POEM is technically feasible and safe, our case series demonstrates poor long-term clinical outcomes across different gastroparesis etiologies. All 3 patients experienced treatment failure, with 2 requiring permanent nutritional support and 1 showing a lack of symptomatic response. These findings may suggest limited utility of redo G-POEM and highlight the need for careful patient selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429251384091","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:41:31Z","timestamp":1759279291000},"page":"892-897","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["First Description of Redo Gastric Per-Oral Endoscopic Myotomy for Refractory Gastroparesis: Technical Conduct and Outcomes"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4414-0446","authenticated-orcid":false,"given":"M\u00e9lissa V.","family":"Wills","sequence":"first","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentin","family":"Mocanu","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sol","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Seoul Medical Center, Seoul, Republic of Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvador","family":"Navarrete","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Strong","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerry","family":"Dang","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Allemang","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Kroh","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2019-318712"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001874"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.02.027"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2024.08.024"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2025.116203"},{"key":"e_1_3_4_7_2","first-page":"S1542","article-title":"A new international scheme for the classification and management of clinical outcomes post-gastric peroral endoscopic myotomy","author":"Ichkhanian Y","year":"2025","unstructured":"Ichkhanian Y, , Salame M, , Wo JM, et al. A new international scheme for the classification and management of clinical outcomes post-gastric peroral endoscopic myotomy. Clin Gastroenterol Hepatol, 2025:S1542.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2022.03.025"},{"key":"e_1_3_4_9_2","unstructured":"Challenges of sarcoidosis and its management | New England Journal of Medicine [Internet]. [cited 2025 July 1]; Available from: https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMra2101555?utm_source=openevidence"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.09.064"}],"container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10926429251384091","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10926429251384091","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10926429251384091","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:00:59Z","timestamp":1777694459000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10926429251384091"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":9,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11,1]]}},"alternative-id":["10.1177\/10926429251384091"],"URL":"https:\/\/doi.org\/10.1177\/10926429251384091","relation":{},"ISSN":["1092-6429","1557-9034"],"issn-type":[{"value":"1092-6429","type":"print"},{"value":"1557-9034","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]}}}