Wisconsin's Enterra Therapy Experience: A multi-institutional review of gastric electrical stimulation for medically refractory gastroparesis. Surgery 2018 Oct;164(4):760-765
Date
08/04/2018Pubmed ID
30072246DOI
10.1016/j.surg.2018.04.043Scopus ID
2-s2.0-85050700720 (requires institutional sign-in at Scopus site) 24 CitationsAbstract
BACKGROUND: Gastric electrical stimulation is a treatment for symptoms of diabetic or idiopathic gastroparesis refractory to medical management. We sought to evaluate the outcomes of gastric electrical stimulation in the state of Wisconsin during a more than 10-year period.
METHODS: Data were collected prospectively from patients undergoing implantation of the gastric electrical stimulation to initiate gastric electrical stimulation therapy at two Wisconsin institutions from 2005-2017. The Gastroparesis Cardinal Symptom Index was administered during clinical encounters and over the phone preoperatively and postoperatively.
RESULTS: A total of 119 patients received gastric electrical stimulation therapy (64 diabetic and 55 idiopathic). All devices were placed laparoscopically. Mean follow-up was 34.1 ± 27.2 months in diabetic and 44.7 ± 26.2 months in idiopathic patients. A total of 18 patients died during the study interval (15.1%). No mortalities were device-related. Diabetics had the greatest rate of mortality (25%; mean interval of 17 ± 3 months post implantation). GCSI scores improved, and prokinetic and narcotic medication use decreased significantly at ≥1 year. Satisfaction scores were high.
CONCLUSION: Gastric electrical stimulation therapy led to the improvement of symptoms of gastroparesis and a better quality of life. Patients were able to decrease the use of prokinetic and narcotic medications and achieve long-term satisfaction. Diabetic patients who develop symptomatic gastroparesis have a high mortality rate over time.
Author List
Shada A, Nielsen A, Marowski S, Helm M, Funk LM, Kastenmeier A, Lidor A, Gould JCAuthors
Jon Gould MD Chief, Professor in the Surgery department at Medical College of WisconsinAndrew Sean Kastenmeier MD Associate Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAged
Electric Stimulation Therapy
Electrodes, Implanted
Female
Gastroparesis
Humans
Laparoscopy
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Wisconsin