Laparoscopy shortens length of stay in patients with gastric electrical stimulators.
BACKGROUND
Gastric electrical stimulation has been proven effective for drug-refractory gastroparesis. Placement of stimulator leads and device usually requires a laparotomy, although laparoscopic placement has also been used.


METHODS
To compare laparotomy with laparoscopy, we examined 36 patients, 18 undergoing laparoscopy and 18 undergoing laparotomy, matched for primary diagnosis and health resource usage. We compared baseline symptoms, length of surgery, length of postoperative hospital stay, gastric emptying, and health resources in each of the 2 groups over time, to see what variables, if any, differed.


RESULTS
Baseline symptoms, gastric emptying, and health resource usage were similar. Operative times were also similar, but length of stay declined from a mean of 6.4 days for laparotomy to 1.1 days for laparoscopy. Long-term outcome, via symptoms, gastric emptying, and health resource utilization were comparable between the 2 groups.


CONCLUSIONS
Laparoscopic placement of gastric electrical stimulator leads and device is associated with shorter lengths of postoperative hospital stay. However, the patients who underwent laparotomy had higher vomiting scores and more previous abdominal surgeries at baseline, and higher long-term mortality at follow-up, suggesting that they may be more ill, as a group, than the laparoscopic patients. Laparoscopic placement of devices may be preferable when technically feasible.
Al-Juburi
Amar
A
Department of Medicine, Division of Gastroenterology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Granger
Stephanie
S
Barnes
James
J
Voeller
Guy
G
Beech
Derrick
D
Amiri
Hosein
H
Abell
Thomas L
TL
D000328:Adult; D016022:Case-Control Studies; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D005500:Follow-Up Studies; D005746:Gastric Emptying; D018589:Gastroparesis / Q000628:therapy*; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D007902:Length of Stay / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D013997:Time Factors; D014839:Vomiting / Q000453:epidemiology