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Preoperative Predictors of Significant Symptomatic Response After 1 Year of Gastric Electrical Stimulation for Gastroparesis

World Journal of Surgery volume 34, pages 1853–1858 (2010)Cite this article

Abstract

Background

In cases of gastroparesis where significant symptoms fail to respond to standard medical therapy, gastric electrical stimulation (GES) may be of benefit. Unfortunately, not all patients improve with this therapy. Reliable preoperative predictors of symptomatic response to GES may allow clinicians to offer this expensive and invasive treatment to only those patients most likely to benefit.

Methods

Therapy was initiated in 15 patients more than 12 months prior to this retrospective review of our prospectively maintained data. All patients completed a Total Symptom Score (TSS) survey at every encounter as well as the SF-36 quality-of-life instrument prior to surgery. A failure of GES therapy was considered to have occurred when after 1 year of treatment, preoperative TSS had not decreased by at least 20%.

Results

Four patients (4 idiopathic) failed to improve more than 20% on multiple assessments after a year of therapy. All diabetic patients experienced a durable symptomatic improvement with GES. Review of individual items of the TSS revealed that nonresponders experienced less severe vomiting preoperatively.

Conclusions

Diabetic gastroparesis patients respond best to GES. Responders tend to have more severe vomiting preoperatively. Patients with idiopathic gastroparesis who do not experience severe vomiting should be cautioned about a potentially higher rate of poor response to GES and may be better served with alternative treatments.

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Affiliations

  1. Department of Surgery, University of Wisconsin School of Medicine and Public Health, H4/726 Clinical Science Center, 600 Highland Avenue, Madison, WI, 53792, USA

    Sandeepa Musunuru, Gretchen Beverstein & Jon Gould

Authors
  1. Sandeepa Musunuru
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  2. Gretchen Beverstein
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  3. Jon Gould
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Corresponding author

Correspondence to Jon Gould.

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Musunuru, S., Beverstein, G. & Gould, J. Preoperative Predictors of Significant Symptomatic Response After 1 Year of Gastric Electrical Stimulation for Gastroparesis. World J Surg 34, 1853–1858 (2010). https://doi.org/10.1007/s00268-010-0586-1

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  • DOI: https://doi.org/10.1007/s00268-010-0586-1

Keywords

  • Physical Component Summary
  • Mental Component Summary
  • Gastroparesis
  • Total Symptom Score
  • Gastric Electrical Stimulation