Safety of same-day discharge after gastric peroral endoscopic myotomy in patients with refractory gastroparesis: an international multicenter study

Background and Aims: The postoperative management of gastric peroral endoscopic myotomy (G-POEM) lacks standardization. This study aimed to evaluate adverse events, readmission rates, and feasibility of same-day discharge (SDD) after G-POEM. Methods: A multicenter retrospective review of prospectively collected G-POEM data was conducted. The primary outcome was the 15-day readmission rates in SDD and admitted patients. Secondary outcomes included readmission risk factors, clinical success, and adverse events (AEs). Results: We found a 4.1% 15-day readmission rate in 482 patients (95% CI, 3.2%-5.4%). SDD clinical success rates at 6 to 12 months were 54.1% versus 59.7% for the admitted group. The overall AE rate was 4.1%. SDD patients tended to have shorter procedure times and higher frequencies of double myotomy and endoscopic suturing for closure. Conclusions: G-POEM is safe with low incidence of AEs and 15-day readmission rates. SDD appears safe in uncomplicated cases, suggesting that upper gastrointestinal studies after G-POEM may be unnecessary. ClinicalTrials.gov (NCT04434781).