Gastric electrical stimulation for gastroparesis

October's issue of Archives of Surgery finds that gastric electrical stimulation increased body mass index, improves symptoms and gastric emptying rates, and is an alternative to gastrectomy for end-stage gastric disease.

Dr Rodney Mason and colleagues considered gastric electrical stimulation as an alternative to gastrectomy in patients with refractory gastroparesis.

The team conducted retrospective case series with a median follow-up of 20 months.

The researchers undertook the research in a tertiary care university hospital and a university-affiliated community hospital.

The team included 29 patients, of which 22 were women with a median age of 39 years with debilitating gastroparesis.

The patients were referred for gastrectomy from 2001 through 2004.

Body mass index improved from 23 preoperatively to 25 postoperatively

Archives of Surgery

The researchers reported that 24 patients had type 1 diabetic gastroparesis and 5 patients had idiopathic gastroparesis.

A gastric stimulator device was placed laparoscopically in 24 patients and by laparotomy in 5 patients.

The main outcome measures included morbidity and mortality of the procedure, symptom control, and hospital readmissions.

Further outcomes measured by the team were need for supplemental nutritional support, body mass index, and gastric emptying.

Follow-up results were available in 27 patients, and the team noted that there was no 30-day mortality or morbidity in 4 patients.

The median hospital stay was 3 days, and all of the patients tolerated an oral diet at discharge.

The researchers found that symptom control was excellent to good in 19 patients.

Nutritional support was discontinued in the 19 patients who were dependent on supplemental feeding before the procedure.

The research team observed that median body mass index improved significantly from 23 preoperatively to 25 postoperatively.

The median gastric emptying rate measured in 15 of 27 patients postoperatively improved from 0.2 per minute preoperatively to 0.4% per minute postoperatively.

Additional procedures were required in 4 patients, owing to poor outcome in 3 patients.

Dr Mason's team concludes, “Gastric electrical stimulation ameliorated symptoms, returned patients to normal oral nutritional intake, increased body mass index, improved gastric emptying rates, and is an alternative to gastrectomy in patients with end-stage gastric disease.”