Effects of Temporary Gastric Electrical Stimulation With Endoscopically Placed Electrodes: A Report Of 41 Consecutive Patients

Abstract

Purpose: We have previously demonstrated that short term gastric electrical stimulation (GES) can be performed with electrodes placed through PEG tubes or via an upper endoscope (Neurogastroenterol Motility 14: 422, 2002). We now report on 41 consecutive patients receiving temporary endoscsopic GES electrode placement to deliniate their characteristics. Methods: 41 patients with the symptoms of gastroparesis and documented disordered gastric emptying (GET) underwent endoscopic placement of electrodes. Patients were 9 m, 32 f with a diagnosis of 27 Idiopathic, 5 Diabetes Mellitus, 9 Post Surgical, mean age 42 years. Endoscopic placement was performed as previously reported using an upper endoscope, a 7F gastric stimulation electrode, and several endoscopically placed clips, fixing the electrode at the antral-body junction. GES was preformed as previously reported (Digestion 66: 204-212, 2002) as were GET and EGG and reported as mean SE. Symptoms of nausea and vomiting (0-4) and GI total symptom score (TSS 0-20) were quantified. Results: Of the 41 patients, all 41 had successful placement of GES electrodes. 36 patients retained the electrodes for at least 3 days, allowing measurement of symptoms and a repeat GET. The symptoms and related characteristics are reported in the table. Of the 41 patients, 39 reported significant improvement in nausea, vomiting, the GI total symptom score (TSS). GET EGG changes were not significantly different although GET % retention did improve and approached significance at 4 Hr. There were no complications of the procedure, and stimulator electrodes were removed easily at the end of the temporary GES period. Conclusion: We conclude that temporary gastric stimulation electrodes are safely and reliably placed endoscopically and that clinically useful information is quickly obtained, without requiring a surgical procedure.