Faculty Collaboration Database

Preoperative predictors of significant symptomatic response after 1 year of gastric electrical stimulation for gastroparesis. World J Surg 2010 Aug;34(8):1853-8

Date

04/23/2010

Pubmed ID

20411386

DOI

10.1007/s00268-010-0586-1

Scopus ID

2-s2.0-77955469586 (requires institutional sign-in at Scopus site)   25 Citations

Abstract

BACKGROUND: In cases of gastroparesis where significant symptoms fail to respond to standard medical therapy, gastric electrical stimulation (GES) may be of benefit. Unfortunately, not all patients improve with this therapy. Reliable preoperative predictors of symptomatic response to GES may allow clinicians to offer this expensive and invasive treatment to only those patients most likely to benefit.

METHODS: Therapy was initiated in 15 patients more than 12 months prior to this retrospective review of our prospectively maintained data. All patients completed a Total Symptom Score (TSS) survey at every encounter as well as the SF-36 quality-of-life instrument prior to surgery. A failure of GES therapy was considered to have occurred when after 1 year of treatment, preoperative TSS had not decreased by at least 20%.

RESULTS: Four patients (4 idiopathic) failed to improve more than 20% on multiple assessments after a year of therapy. All diabetic patients experienced a durable symptomatic improvement with GES. Review of individual items of the TSS revealed that nonresponders experienced less severe vomiting preoperatively.

CONCLUSIONS: Diabetic gastroparesis patients respond best to GES. Responders tend to have more severe vomiting preoperatively. Patients with idiopathic gastroparesis who do not experience severe vomiting should be cautioned about a potentially higher rate of poor response to GES and may be better served with alternative treatments.

Author List

Musunuru S, Beverstein G, Gould J

Author

Jon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Diabetes Complications
Electric Stimulation Therapy
Female
Gastroparesis
Humans
Male
Middle Aged
Predictive Value of Tests
Quality of Life
Radionuclide Imaging
Retrospective Studies
Statistics, Nonparametric
Treatment Outcome
Vomiting