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.
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