Abstract
Background
Gastric electrical stimulation (GES) has been introduced for patients with gastroparesis
refractory to pharmacological therapy.
Methods
From April 1998 until November 2001, 55 patients underwent GES implantation at Kansas
University Medical Center. All patients had prolonged gastric retention of a solid
meal by scintigraphy at baseline. The etiologies were diabetes mellitus in 39, related
to previous surgery in 9, and idiopathic in 7. Symptoms were graded using a 5-point
scale and quality of life was assessed with the SF-36 questionnaire. Body mass index
and nutritional parameters were monitored. Hemoglobin A1C was measured in the diabetic
patients.
Results
Total symptom scores and the physical and mental composite scores of quality of life
improved significantly. On average, gastric emptying did not change. Body mass index
and body weight increased significantly. And days spent in hospital admissions were
significantly decreased. At 1 year, diabetic patients experienced reduced hemoglobin
A1C. Four devices were removed. One patient died of a pulmonary embolus postoperatively.
Conclusions
In a large series of patients with gastroparesis, GES significantly improved symptoms
and quality of life.
Keywords
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References
- The diagnosis and work-up of the patient with gastroparesis.J Clin Gastroenterol. 2000; 30: 117-124
- Assessment of gastric emptying using a low fat meal.Am J Gastroenterol. 2000; 95: 1456-1462
- Demography, clinical characteristics, psychological and abuse profiles, treatment, and long-term follow-up of patients with gastroparesis.Dig Dis Sci. 1998; 43: 2398-2404
- Prokinetics in patients with gastgroparesis.Digestion. 1999; 60: 422-427
- Surgical therapy of diabetic gastroparesis.J Clin Gastroenterol. 1989; 11: 204-207
- Novel surgical treatment and gastric pathology in diabetic gastroparesis.Diabetic Med. 1999; 16: 488-495
McCallum RW, George SJ. Gastroparesis. Clin Perspect Gastro 2001;May/June:1–9
- Gastric pacing is a new surgical treatment for gastroparesis.Am J Surg. 2001; 182: 676-681
- EUS guidance in gastric pacemaker implantation.Gastrointest Endosc. 2002; 55: 728-730
- SF-36 Physical and mental health summary scales: a users manual.Health Assessment Lab, Boston1994
Abell T, Hocking M, McCallum R, et al. Gastric electrical stimulation for medically refractory gastroparesis. Gastroenterology 2003;125:421–8
- Safety and long-term durability of completion gastrectomy in 81 patients with postsurgical gastroparesis syndrome.Am Surg. 1998; 64: 711-717
- Near-total completion gastrectomy for severe postvagotomy gastric stasis.J Gastrointest Surg. 1999; 3: 15-21
- Delayed gastric emptying and gastric autoimmunity in type 1 diabetes.Diabetes Care. 2002; 25: 912-917
Bityutskiy LP, Soykan I, McCallum RW. Viral gastroparesis: a subgroup of idiopathic gastroparesis—clinical characteristics and long-term outcomes. Am J Gastroenterol 1997;92:1501–4
Lin Z, Forster J, Sarosiek , McCallum RW. Effect of high-frequency electrical stimulation on gastric myoelectric activity in gastroparetic patients. AJP. In press
- The influence of gastric electrical stimulation on proximal gastric motor and sensory function in severe idiopathic gastroparesis.Gastroenterology. 1999; 116: G4733
- Andrenergic and cholinergic measures help predict response to gastric electrical stimulation.Neurogastroenterol Mot. 2002; 14: 432
- Gastric electrical stinmulation is associated with increased pancreatic synthetic function when compared to normals and medical controls.Gastroenterology. 2001; 120: A647
Article info
Publication history
Received in revised form:
August 21,
2003
Received:
July 11,
2003
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
