Pre-operative gastric emptying time correlates with clinical response to gastric electrical stimulation in the treatment of gastroparesis

Abstract Background Gastric electrical stimulation (GES) may be of benefit in cases of gastroparesis that fail to respond to standard medical therapy. Response to this treatment is varied and prediction of clinical improvement is difficult. Methods This was a retrospective review and symptom questio...

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Bibliographic Details
Published in:The surgeon (Edinburgh) 2013-06, Vol.11 (3), p.134-140
Main Authors: O'Loughlin, P.M, Gilliam, A.D, Shaban, F, Varma, J.S
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Electric Stimulation Therapy - methods
Enterra
Female
Follow-Up Studies
Gastric electrical stimulation
Gastric Emptying - physiology
Gastroparesis
Gastroparesis - physiopathology
Gastroparesis - therapy
Humans
Male
Middle Aged
Preoperative Period
Response prediction
Retrospective Studies
Surgery
Surveys and Questionnaires
Time Factors
Treatment Outcome
Young Adult
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Summary:Abstract Background Gastric electrical stimulation (GES) may be of benefit in cases of gastroparesis that fail to respond to standard medical therapy. Response to this treatment is varied and prediction of clinical improvement is difficult. Methods This was a retrospective review and symptom questionnaire survey for all patients who underwent GES insertion in a single institution from November 2008 until May 2010 using the gastroparesis cardinal symptom index (GCSI). Results 14 out of 17 patients who had GES insertion responded to telephone or postal questionnaire. Mean pre-operative gastric emptying time was 151 min (median 146 min, range 18–318). Median follow up was 14 months (range 7–25 months). The mean reduction in GCSI score after GES insertion was 51% (13.4 vs 6.4, Z  = 0.0013). Percentage reduction in GCSI correlated with pre-operative solid gastric emptying time ( p  = 0.0086). Two patients who responded to questionnaire required device removal, one due to a gastric perforation and the other for discomfort related to the implant and a poor clinical response. Conclusions GES significantly improves symptoms of gastroparesis on the GCSI score. Not all patients respond equally to GES, and response may be predicted by pre-operative solid gastric emptying times.
ISSN:1479-666X
2405-5840
DOI:10.1016/j.surge.2012.10.006