title: Long term efficacy of gastric electrical stimulation in intractable nausea and vomiting.
abstract: BACKGROUND
  Although the efficacy of gastric electrical stimulation has been reported in short-term studies, there is a lack of data on the long-term improvement of nausea and vomiting by gastric electrical stimulation in patients with delayed or normal gastric emptying.
  
  
  METHODS
  Thirty-one patients were implanted at our centre for medically refractory severe and chronic nausea and/or vomiting. Patients were evaluated at baseline, 6 months then 5 years after implantation (mean follow-up 80±4 months) using a symptomatic and quality of life scores.
  
  
  RESULTS
  Amongst the 31 patients, 4 were lost to follow-up, 6 explanted due to lack of improvement, and 1 patient died. Out of the 20 patients evaluated over 5 years, the quality of life score showed 27% improvement (p<0.01), including nausea (62%; p<0.01), vomiting (111%; p=0.03), satiety (158%; p<0.01), bloating (67%; p<0.01) and epigastric pain (43%; p=0.03). Over 5 years, 15/20 patients reported a 50% improvement with a global satisfaction rated at 64±6%. Therefore, 15/27 patients (56%) were improved by gastric electrical stimulation over 5 years in intention to treat. Improvement of nausea 6 months after implantation was predictive of 5-year success of gastric electrical stimulation (p=0.04). Finally, patients with delayed gastric emptying or with normal gastric emptying rate before surgery were similarly improved over 5 years (60% versus 50% respectively).
  
  
  CONCLUSIONS
  Gastric electrical stimulation is safe and effective in the long term in patients with medically refractory nausea and vomiting, with an efficacy over 50% beyond 5 years in intention to treat. Gastric emptying measured before implantation did not influence the response rate over 5 years.
authors.affiliation: Department of Physiology and INSERM UMR-1073/IRIB, Rouen University Hospital, University of Rouen, France. guillaume.gourcerol@chu-rouen.fr
authors.forename: Guillaume
authors.initials: G
authors.lastname: Gourcerol
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Huet
authors.forename: Nathalie
authors.initials: N
authors.lastname: Vandaele
authors.forename: Ullrikka
authors.initials: U
authors.lastname: Chaput
authors.forename: Isabelle
authors.initials: I
authors.lastname: Leblanc
authors.forename: Valerie
authors.initials: V
authors.lastname: Bridoux
authors.forename: Francis
authors.initials: F
authors.lastname: Michot
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Leroi
authors.forename: Philippe
authors.initials: P
authors.lastname: Ducrotté
mesh_terms: D015746:Abdominal Pain / Q000628:therapy; D004599:Electric Stimulation Therapy; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying; D005772:Gastrointestinal Transit; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D012527:Satiation / Q000502:physiology; D018709:Statistics, Nonparametric; D013270:Stomach / Q000503:physiopathology*; D013997:Time Factors; D014839:Vomiting / Q000503:physiopathology / Q000628:therapy*