Original Article

Pilot Study on Gastric Electrical Stimulation on Surgery-associated Gastroparesis: Long-term Outcome

Authors: Benton Oubre, MD, Jean Luo, MD, Amar Al-Juburi, MD, Guy Voeller, MD, Babajide Familoni, PHD, Thomas L. Abell, MD

Abstract

Objectives: Patients with postgastric surgery gastroparesis are often unresponsive to conventional medical therapy. Gastric electrical stimulation (GES) with the use of high-frequency and low-energy neural stimulation is an approved technique for patients with idiopathic and diabetic gastroparesis.


Methods: We hypothesized that GES would improve symptoms, health resource utilization, and gastric emptying in six patients with postsurgical gastroparesis from a variety of surgical procedures. Patients were evaluated by means of the following criteria: symptoms, health-related quality of life, and gastric emptying tests at baseline over time.


Results: All patients noted improvements after device implantation for up to 46 months: the frequency score for weekly vomiting went from a baseline of 3.2 down to 0.4 immediately after treatment before settling at 1.4 by the long-term follow up. Total gastrointestinal symptom score went from 36.5 at baseline down to 12.3 before settling at 20.5 at long-term follow up. Improvements were also seen in health-related quality of life and solid and liquid gastric emptying.


Conclusions: We conclude that GES is associated with clinical improvements in this group of patients with either postsurgical or surgery-associated gastroparesis. This pilot study with long-term outcomes offers evidence for a new therapy for otherwise refractory patients with gastroparesis associated with previous surgery.


Key Points


* Gastric electrical (neural) stimulation (GES) differs from gastric pacing.


* Postsurgical patients have not been treated long-term with GES.


* Six consecutive postsurgical patients were treated with GES for up to 4 years.


* Patients had improvement in symptoms, gastric emptying, and health-related quality of life.

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