Gastric Electrical Stimulation for Gastroparesis

被引:44
作者
Brody, Fred [1 ]
Vaziri, Khashayar [1 ]
Saddler, Antoinette [2 ]
Ali, Aamir [2 ]
Drenon, Elizabeth [1 ]
Hanna, Brook [1 ]
Akin, Esma [3 ]
Gonzalez, Florencia [1 ]
Soffer, Edy [4 ]
机构
[1] George Washington Univ, Med Ctr, Dept Surg, Washington, DC 20037 USA
[2] George Washington Univ, Med Ctr, Dept Gastroenterol, Washington, DC 20037 USA
[3] George Washington Univ, Med Ctr, Dept Radiol, Washington, DC 20037 USA
[4] Cedars Sinai Med Ctr, Dept Gastroenterol, Los Angeles, CA USA
关键词
D O I
10.1016/j.jamcollsurg.2008.04.032
中图分类号
R61 [外科手术学];
学科分类号
摘要
BACKGROUND: Recently, gastric electrical stimulation (GES) has been used to treat gastroparesis. This study analyzes a cohort of gastroparetic patients after GES. STUDY DESIGN: 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. RESULTS: 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 I I 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. CONCLUSIONS: 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. (J Am Coll Surg 2008;207: 533-538. (C) 2008 by the American College Of Surgeons)
引用
收藏
页码:533 / 538
页数:6
相关论文
共 25 条
[1]
Gastric electrical stimulation for medically refractory gastroparesis [J].
Abell, T ;
McCallum, R ;
Hocking, M ;
Koch, K ;
Abrahamsson, H ;
LeBlanc, I ;
Lindberg, G ;
Konturek, J ;
Nowak, T ;
Quigley, EMM ;
Tougas, G ;
Starkebaum, W .
GASTROENTEROLOGY, 2003, 125 (02) :421-428
[2]
Treatment of gastroparesis: a multidisciplinary clinical review [J].
Abell, TL ;
Bernstein, RK ;
Cutts, T ;
Farrugia, G ;
Forster, J ;
Hasler, WL ;
McCallum, RW ;
Olden, KW ;
Parkman, HP ;
Parrish, CR ;
Pasricha, PJ ;
Prather, CM ;
Soffer, EE ;
Twillman, R ;
Vinik, AI .
NEUROGASTROENTEROLOGY AND MOTILITY, 2006, 18 (04) :263-283
[3]
Gastric electrical stimulation in intractable symptomatic gastroparesis [J].
Abell, TL ;
Van Cutsem, E ;
Abrahamsson, H ;
Huizinga, JD ;
Konturek, JW ;
Galmiche, JP ;
Voeller, G ;
Filez, L ;
Everts, B ;
Waterfall, WE ;
Domschke, W ;
des Varannes, SB ;
Familoni, BO ;
Bourgeois, IM ;
Janssens, J ;
Tougas, G .
DIGESTION, 2002, 66 (04) :204-212
[4]
Laparoscopic insertion of gastric electrodes for electrical stimulation [J].
Brody, Fred ;
Nam, Arthur ;
Drenon, Elizabeth ;
Ali, Aamir ;
Soffer, Edy .
JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES, 2007, 17 (01) :1-6
[5]
Is gastric electrical stimulation superior to standard pharmacologic therapy in improving GI symptoms, healthcare resources, and long-term health care benefits? [J].
Cutts, TF ;
Luo, J ;
Starkebaum, W ;
Rashed, H ;
Abell, TL .
NEUROGASTROENTEROLOGY AND MOTILITY, 2005, 17 (01) :35-43
[6]
Novel surgical treatment and gastric pathology in diabetic gastroparesis [J].
Ejskjaer, NT ;
Bradley, JL ;
Buxton-Thomas, MS ;
Edmonds, ME ;
Howard, ER ;
Purewal, T ;
Thomas, PK ;
Watkins, PJ .
DIABETIC MEDICINE, 1999, 16 (06) :488-495
[7]
Electrical stimulation at a frequency higher than basal rate in human stomach [J].
Familoni, BO ;
Abell, TL ;
Voeller, G ;
Salem, A ;
Gaber, O .
DIGESTIVE DISEASES AND SCIENCES, 1997, 42 (05) :885-891
[8]
Impaired accommodation of proximal stomach to a meal in functional dyspepsia [J].
Gilja, OH ;
Hausken, T ;
Wilhelmsen, I ;
Berstad, A .
DIGESTIVE DISEASES AND SCIENCES, 1996, 41 (04) :689-696
[9]
The diagnosis and work-up of the patient with gastroparesis [J].
Hornbuckle, K ;
Barnett, JL .
JOURNAL OF CLINICAL GASTROENTEROLOGY, 2000, 30 (02) :117-124
[10]
GASTRIC AND ESOPHAGEAL EMPTYING IN PATIENTS WITH TYPE-2 (NON-INSULIN-DEPENDENT) DIABETES-MELLITUS [J].
HOROWITZ, M ;
HARDING, PE ;
MADDOX, AF ;
WISHART, JM ;
AKKERMANS, LMA ;
CHATTERTON, BE ;
SHEARMAN, DJC .
DIABETOLOGIA, 1989, 32 (03) :151-159