Gastric electrical stimulation for gastroparesis.

Abstract

Recently, gastric electrical stimulation (GES) has been used to treat gastroparesis. This study analyzes a cohort of gastroparetic patients after GES. All patients undergoing GES from October 2003 to July 2007 were included. Pre- and postoperative assessments were performed for frequency and severity of gastrointestinal symptoms and gastric retention. The values were compared using a paired t-test for patients at 6 and 12 months. Statistical significance was defined as p < 0.05. Fifty gastroparetic patients were enrolled (20 diabetic, 25 idiopathic, 2 postsurgical, and 3 connective tissue disorder patients). All patients underwent laparoscopic implantation with GES (Medtronic, Inc). Median followup was 28 months (range 3 to 51 months). Thirty-five patients were available for followup at 6 months, and 30 patients were available at 12 months. The total symptom severity score (19.05+/-8.04) decreased significantly at 6 months (12.92+/-7.41, p < 0.001) and 12 months (14.05+/-8.28, p < 0.01). Similarly, total frequency score (20.39+/-8.08) decreased significantly at 6 months (15.01+/-7.37, p < 0.01) and 12 months (15.71+/-7.40, p < 0.05). At 12 months (n=27), gastric retention at 2 hours was decreased significantly from 66% +/- 21% to 50% +/- 22% (p < 0.04) and normalized in 11 of 27 patients. The severity of symptoms was reduced in all patients with normal gastric retention postoperatively. Finally, gastric retention at 4 hours was reduced by 14%, but the difference was not significant. Gastroparetic symptoms at 6 months were improved and sustained at 12 months after GES. Gastric emptying at 2 hours was reduced significantly after GES. Longterm followup of this cohort is required to confirm the short-term effects of GES.