Amber Shada1, Alex Nielsen2, Sarah Marowski1, Melissa Helm2, Luke M Funk3, Andrew Kastenmeier2, Anne Lidor1, Jon C Gould4. 1. Department of Surgery, Division of General Surgery, University of Wisconsin, Madison. 2. Department of Surgery, Division of General Surgery, Medical College of Wisconsin, Milwaukee; and. 3. Department of Surgery, Division of General Surgery, University of Wisconsin, Madison;; William S. Middleton Memorial Veterans Hospital, Madison, WI. 4. Department of Surgery, Division of General Surgery, Medical College of Wisconsin, Milwaukee; and. Electronic address: jgould@mcw.edu.
Abstract
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.
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. Diabeticpatients who develop symptomatic gastroparesis have a high mortality rate over time.
Authors: Sarah Marowski; Yiwei Xu; Jake A Greenberg; Luke M Funk; Anne O Lidor; Amber L Shada Journal: Surg Endosc Date: 2020-10-06 Impact factor: 4.584
Authors: Henry P Parkman; Laura A Wilson; Gianrico Farrugia; Kenneth L Koch; William L Hasler; Linda A Nguyen; Thomas L Abell; William Snape; John Clarke; Braden Kuo; Richard W McCallum; Irene Sarosiek; Madhusudan Grover; Laura Miriel; James Tonascia; Frank A Hamilton; Pankaj J Pasricha Journal: Am J Gastroenterol Date: 2019-11 Impact factor: 10.864
Authors: Thomas L Abell; Goro Yamada; Richard W McCallum; Mark L Van Natta; James Tonascia; Henry P Parkman; Kenneth L Koch; Irene Sarosiek; Gianrico Farrugia; Madhusudan Grover; William Hasler; Linda Nguyen; William Snape; Braden Kuo; Robert Shulman; Frank A Hamilton; Pankaj J Pasricha Journal: Neurogastroenterol Motil Date: 2019-10-04 Impact factor: 3.598