Abstracts
1999 Digestive Disease Week

# 4670 GASTRIC ELECTRICAL STIMULATION IMPROVES BOTH GI SYMPTOMS AND GASTRIC EMPTYING IN PATIENTS WITH "POST-SURGICAL" GASTROPARESIS.
Jean Luo, Thomas L. Abell, Paula Eaton, Guy Voeller, Univ of Tenn, Memphis, Memphis, TN

Introduction. Patients with surgery-related gastric motor disorders remain one of the most difficult and refractory groups of patients (pts). Gastric Electrical Stimulation (GES) has shown promise for other pts with gastroparesis (GP) but has not been applied to post-surgical disorders. Patients. We studied 5 pts, a subset of the GEMS trial, 2m, 3f, mean age 38.2 yrs., who had 'surgery-related' GP of long duration (mean 86 months). Pts had a variety of surgical procedures (i.e. gastrojejunostomy, partial gastrectomy, Nissen fundoplication, vagotomy, and pyloroplasty), and 3 pts had Sx which had predated their surgery. Methods. Pts were evaluated for Sx by Total Symptom Score (TSS) and gastric emptying (GET) both at baseline, and after temporary (TEMP) and permanent (PERM) GES (mean 14.2 months), using an Itrel (Medtronics), as previously described for the GEMS trial (GE 112(4): A735, 1997). Results were compared by paired t-tests and by %improvement, and were reported as mean±SE. Results. All patients noted an immediate (< 7 days) reduction in Sx (TSS 38.75±2.66 at baseline vs. 11.75±7.43 post-temporary, a 73.5% improvement, p < 0.05) and an improvement in both solid and liquid GET (see table). Pts' weight and BMI also increased (4.1% and 4.3%, respectively) at 6 month post-PERM implant, and all pts had decreased or discontinued supplemental feeding after TEMP implant. Conclusion. We conclude that in this group of 'surgery-related gastroparesis' patients, gastric electrical stimulation (GES) shows significant improvement in both symptoms and gastric emptying, and that the improvement is sustained over time. GES deserves further investigation, in controlled trials, in pts with post-surgical gastric motor disorders.

% improvement	TSS	Liquid GET	Solid GET	PO Feeding
Post-TEMP	73.5	47.4	37.1	50%
3 mo.post-PERM	74.3	20.7	7.1	50%
6 mo.post-PERM	86.0	37.4	28.3	50%

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