[Gastric electrostimulation in refractory gastroparesis: results of a explorative observational study]

Abstract

High-frequency electrical stimulation therapy (gastric electrical stimulation, GES) is a treatment option for gastroparesis of various genesis. The best indication and prognostic parameters have not yet been conclusively determined.Retrospective analysis of all gastroparesis patients implanted with a GES device between 2011 and 2020. Clinical response was measured before and after implantation using a validated Gastroparesis Cardinal Symptom Index (GCSI) (maximum score: 5, minimum score: 0). Other study endpoints included: subjective symptom course (no improvement, partial improvement, or severe improvement) and change in gastroparesis medication.A GES device was implanted in 42 patients (16 M: 26 F, mean age 45 years). The etiology of gastroparesis was diabetic (n=23), idiopathic (n=10) or postoperative (n=9). Eleven patients (26%) had undergone one or more invasive treatments before. GCSI score of the total group was 3.23 preoperatively. The median follow-up time was 12 months. In the overall group, significant improvement in GCSI score was found 3, 6, 9, and 12 months postoperatively-regardless of indication. In multivariate analysis, disease duration of >30 months was associated with a significantly decreased GCSI score at 12 months (p<0.001). Approximately 40% of patients were able to discontinue or significantly reduce gastroparesis medication. At the end of follow-up, 81% of patients reported partial or major improvement in symptoms. During the follow-up period, three patients (7%) died.Gastric electrical neurostimulation is an effective and safe option for refractory gastroparesis-regardless of the underlying disease.