Long term efficacy of gastric electrical stimulation in intractable nausea and vomiting

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• 作者：Guillaume Gourcerol^a ; ^d ; ^{guillaume.gourcerol@chu-rouen.fr} ; Emmanuel Huet^b ; Nathalie Vandaele^a ; Ullrikka Chaput^a ; Isabelle Leblanc^b ; Valerie Bridoux^b ; Francis Michot^b ; Anne Marie Leroi^a ; ^d ; Philippe Ducrott&eacute ; ^c
• 关键词：Gastroparesis ; Gastric emptying ; Gastric electrical stimulation ; Nausea ; Vomiting
• 刊名：Digestive and Liver Disease
• 出版年：2012
• 期刊代码：79_15908658
• 类别：med
• 出版时间：July, 2012
• 卷：44
• 期：7
• 页码：563-568
• 文件大小：327 K

摘要

Background

Although the efficacy of gastric electrical stimulation has been reported in short-term studies, there is a lack of data on the long-term improvement of nausea and vomiting by gastric electrical stimulation in patients with delayed or normal gastric emptying.

Methods

Thirty-one patients were implanted at our centre for medically refractory severe and chronic nausea and/or vomiting. Patients were evaluated at baseline, 6 months then 5 years after implantation (mean follow-up 80 卤 4 months) using a symptomatic and quality of life scores.

Key results

Amongst the 31 patients, 4 were lost to follow-up, 6 explanted due to lack of improvement, and 1 patient died. Out of the 20 patients evaluated over 5 years, the quality of life score showed 27%improvement (p < 0.01), including nausea (62%; p < 0.01), vomiting (111%; p = 0.03), satiety (158%; p < 0.01), bloating (67%; p < 0.01) and epigastric pain (43%; p = 0.03). Over 5 years, 15/20 patients reported a 50%improvement with a global satisfaction rated at 64 卤 6%. Therefore, 15/27 patients (56%) were improved by gastric electrical stimulation over 5 years in intention to treat. Improvement of nausea 6 months after implantation was predictive of 5-year success of gastric electrical stimulation (p = 0.04). Finally, patients with delayed gastric emptying or with normal gastric emptying rate before surgery were similarly improved over 5 years (60%versus 50%respectively).

Conclusion

Gastric electrical stimulation is safe and effective in the long term in patients with medically refractory nausea and vomiting, with an efficacy over 50%beyond 5 years in intention to treat. Gastric emptying measured before implantation did not influence the response rate over 5 years.