title: Gastric electrical stimulation improves outcomes of patients with gastroparesis for up to 10 years.
abstract: OBJECTIVE
  We assessed the long-term clinical outcomes of gastric electrical stimulation (GES) therapy with Enterra (Enterra Therapy System; Medtronic, Minneapolis, MN) in a large cohort of patients with severe gastroparesis.
  
  
  METHODS
  Gastroparesis patients (n=221; 142 diabetic, 48 idiopathic, and 31 postsurgical) treated with Enterra (Medtronic) for 1-11 years were retrospectively assessed; 188 had follow-up visits and data were collected for at least 1 year (mean 56 months, range 12-131 months). Total symptom scores (TSSs), gastric emptying, nutritional status, weight, hospitalizations, use of prokinetic and/or antiemetic medications, levels of HbA1c levels (in diabetic patients), and adverse events were evaluated at the beginning of the study (baseline) and during the follow-up period.
  
  
  RESULTS
  TSS, hospitalization days, and use of medications were significantly reduced among all patients (P<.05). More patients with diabetic (58%) and postsurgical gastroparesis (53%) had a greater than 50% reduction in TSS than those with idiopathic disease (48%; P=.32). Weight significantly increased among all groups, and 89% of J-tubes could be removed. At end of the follow-up period, all etiological groups had similar, abnormal delays in mean gastric retention. Thirteen patients (7%) had their devices removed because of infection at the pulse generator site.
  
  
  CONCLUSIONS
  GES therapy significantly improved subjective and objective parameters in patients with severe gastroparesis; efficacy was sustained for up to 10 years and was accompanied by good safety and tolerance profiles. Patients with diabetic or postsurgical gastroparesis benefited more than those with idiopathic disease.
authors.affiliation: Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, Texas 79905, USA. richard.mccallum@ttuhsc.edu
authors.forename: Richard W
authors.initials: RW
authors.lastname: McCallum
authors.forename: Zhiyue
authors.initials: Z
authors.lastname: Lin
authors.forename: Jameson
authors.initials: J
authors.lastname: Forster
authors.forename: Katherine
authors.initials: K
authors.lastname: Roeser
authors.forename: Qingjiang
authors.initials: Q
authors.lastname: Hou
authors.forename: Irene
authors.initials: I
authors.lastname: Sarosiek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D048909:Diabetes Complications / Q000628:therapy; D004558:Electric Stimulation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D018589:Gastroparesis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult