Gastric electrical stimulation is an effective and safe treatment for medically refractory gastroparesis.
BACKGROUND
Gastroparesis is characterized by delayed gastric emptying in the absence of obstruction. Common symptoms include nausea, vomiting, and abdominal pain. Severe gastroparesis can result in recurrent hospitalizations, malnutrition, and even death. Gastric electrical stimulation (GES) is a low morbidity treatment that may be effective in patients who are refractory to medical therapy.


METHODS
For a period of more than 35 months, 19 GES systems were implanted laparoscopically for refractory gastroparesis of diabetic (DG, n = 10), idiopathic (IG, n = 6), or postsurgical (PSG, n = 3) etiology. Total gastroparesis symptom scores (TSS) and weekly vomiting frequency were assessed. Gastric emptying studies were attained preoperatively and after 6 months.


RESULTS
Mean follow-up was 38 weeks. There were no major complications. Within 6 weeks, frequency of vomiting decreased in 75% of DG (6/8) and 100% of IG (4/4) patients. No PSG patient complained of vomiting preoperatively. Mean TSS scores improved significantly at all intervals out to 1 year. Gastric emptying studies normalized in 80% of DG patients but in only 1 of the 6 patients with gastroparesis due to other causes.


CONCLUSIONS
GES therapy can lead to improvement in symptoms of gastroparesis and frequency of vomiting within 6 weeks. This therapy is a low morbidity treatment option that may help patients whose symptoms fail to improve with medical therapy.
McKenna
Daniel
D
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Beverstein
Gretchen
G
Reichelderfer
Mark
M
Gaumnitz
Eric
E
Gould
Jon
J
D015331:Cohort Studies; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying / Q000502:physiology; D018589:Gastroparesis / Q000175:diagnosis* / Q000628:therapy*; D005773:Gastroscopy / Q000379:methods; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011336:Probability; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome