Efficacy of gastric electrical stimulation in intractable nausea and vomiting at 10 years: A retrospective analysis of prospectively collected data.

Abstract

Gastric electrical simulation has been shown to relieve nausea and vomiting in medically refractory patients. Efficacy of gastric electrical stimulation has been reported mostly in short-term studies, but none has evaluated its efficacy beyond 10years after implantation. Patients implanted at our center for medically refractory severe and chronic nausea and/or vomiting were evaluated before and over 10years after implantation using symptomatic scale and quality of life (GIQLI) score. Improvement was defined as a reduction of more than 50% in vomiting frequency. A total of 50 patients were implanted from January 1998 to December 2009. Among them, 7 were explanted due to a lack of efficacy and/or side effects, 2 died, and 4 were lost to follow-up. Mean follow-up was 10.5±3.7years. In intention-to-treat analysis, 27/50 (54%) patients reported an improvement. Beyond 10years, an improvement in early satiety (3.05 vs 1.76, <0.001), bloating (2.51 vs 1.70, P=.012), nausea (2.46 vs 1.35, P=.001), and vomiting (3.35 vs 1.49 P<.001) scores were observed. Quality of life improved over 10years (GIQLI score: 69.7 vs. 86.4, P=.005) and body mass index (BMI: 23.4 vs. 26.2kg/m2 ; P=.048). Gastric electrical simulation is effective in the long-term in patients with medically refractory nausea and vomiting, with an efficacy of 54% at 10years on an intention-to-treat analysis. Other long-term observational studies are warranted to confirm these results.