Introduction Gastric per oral endoscopic myotomy (G-POEM) has emerged as an effective minimally invasive therapy for refractory gastroparesis. However, post-procedural care remains variable across centers, with no clear consensus on whether patients require routine overnight observation or can be safely discharged on the same day.
Introduction
Gastric per oral endoscopic myotomy (G-POEM) has emerged as an effective minimally invasive therapy for refractory gastroparesis. However, post-procedural care remains variable across centers, with no clear consensus on whether patients require routine overnight observation or can be safely discharged on the same day.
Problem Statement
Despite growing adoption of G-POEM, the optimal post-procedure disposition remains undefined. Routine overnight admission increases resource utilization and costs, yet concerns persist regarding delayed adverse events, unplanned readmissions and emergency visits after same-day discharge. Defining the safety of same-day discharge is essential to standardize post-G-POEM care and improve procedural efficiency.
Summary
This systematic review and meta-analysis suggests that same-day discharge after G-POEM is a safe and feasible strategy in appropriately selected patients with refractory gastroparesis. Across pooled studies, same-day discharge was not associated with higher rates of readmission, emergency department visits or procedure-related adverse events compared with routine overnight observation. These findings support the clinical safety of same-day discharge when applied in carefully selected patients following uncomplicated procedures. Notably, same-day discharge was also associated with shorter procedure times, suggesting that procedural efficiency and case selection may contribute to successful early discharge pathways. Although patient selection and institutional protocols remain important, these data support a shift toward more streamlined post-G-POEM care and suggest that routine overnight admission may not be necessary for all patients. This analysis provides an important step toward standardizing post-procedural pathways and supports same-day discharge as a practical, resource-conscious approach in experienced centers.
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