HEALTH SERVICES UTILIZATION OF PATIENTS WITH GASTROPARESIS TREATED WITH GASTRIC NEUROSTIMULATION WITH AND WITHOUT CONCOMITANT PYLOROPLASTY OR SUBSEQUENT PYLOROMYOTOMY
Graham Davis*1, Langfeier Liu1, Karla Bernardi2, William Allen1, Adham R. Saad1, Joseph Sujka1, Vic Velanovich1
1Surgery, University of South Florida, Tampa, FL; 2University of Pittsburgh, Pittsburgh, PA
Background: The surgical treatment of gastroparesis is gastric neurostimulaton (GN), laparoscopic/open pyloromyotomy (PY), and/or per-oral pyloromyotomy (POP). How these treatments affect subsequent health care utilization is poorly understood.
Methods: Medical records of patients undergoing surgical treatment for gastroparesis from 2012-2019 were reviewed. Patients were divided into three groups: GN alone, GN + pyloromyotomy, and GN + delayed pyloromyotomy. Primary outcome: number of readmissions. Secondary outcomes: number of emergency room visits, surgical site occurrences, number of GN setting adjustments, and patient-reported symptom relief.
Results: 78 patients were included: 49 GN alone, 12 GN + pyloromyotomy, and 17 GN + delayed pyloromyotomy. Median readmissions (range): GN alone 0 (0-26), GN + pyloroplasty 0 (0-4), GN + delayed pyloromyotomy 1 (0-9) (p-value= 0.29). However, patients significantly differed in the number of GP setting adjustments (p-value= 0.001), number of repositionings or replacements (p-value= 0.008) and total follow-up months (p-value= 0.001).
Conclusions: Readmissions did not differ among groups. However, the number of office visits needed for GN setting adjustments was lowest in the GP alone group, the number of repositionings/replacements was lowest in the GN + pyloromyotomy group and the number of follow-up months was highest among the GN + delayed pyloromyotomy group.
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