2 Endoscopic temporary gastric electrical stimulation – results of 140 consecutive patients

Abstract

Introduction: Gastric electrical stimulation (GES) is now an accepted therapy for drug refractory gastroparesis, but requires surgical device implantation. We recently described techniques for placement of temporary GES electrodes via PEG tube or endoscope (GIE 2005: 61:455–461). We now report on a larger series of consecutive patients referred for endoscopic temporary stimulation.Patients: 140 consecutive patients, 29 male, 114 female, mean age 41 years, with the diagnosis of diabetes (DM, n = 44), post‐surgical (PS, n = 14) or idiopathic disorders (ID, n = 82) were evaluated. We investigated those patients who were successfully implanted, and those who completed a full evaluation of symptoms and gastric emptying tests.Methods: All patients underwent baseline assessment of Symptoms (SX, as Nausea = N, Vomiting = V, Total GI Sx = TSS) and measurements of Gastric emptying (GET) and again after a minimum of 3 days of GES with standard parameters (GIE, above). Patients were reported by descriptive statistics and by t‐tests for symptoms and emptying.Results: 139 (99%) of patients were successfully implanted and 125 (88%) of patients completed at least 3 days of therapy. Of thepatients who completed a full evaluation, there were significant improvements in symptoms and improvements in gastric emptying for some patients: particularly PS and DM (See table).Conclusion: Temporary endoscopic gastric electrical stimulation is feasable and reproducible in a large numbers of patients. The availability of this technique, combined with an emerging technology of gastrointestinal electrical stimulation techniques, gives endoscopists the ability to screen patients before implantation of permanent devices. The availability of endoscopic implanted electrical stimulation offers other potential therapeutic uses, including dyspepsia, post‐surgical disorders and obesity. Category B T B T B T B/ T Measure N N V v TSS TSS 4 Hr/ 4 Hr All 3.4 0.9 2.5 0.6 15.2 5.1 20.7 20.6 DM 3.2 0.7 2.6 0.3 14.3 3.2 23.4 20.5 ID 3.2 0.8 2.2 0.6 14.7 4.7 12.9 13.1 PS 3.2 0.2 2.6 0.2 14.1 2.1 28.3 15.8 P <0.0001 <0.0001 <0.0001