PMID- 23113904
OWN - NLM
STAT- MEDLINE
DCOM- 20130910
LR  - 20130122
IS  - 1365-2982 (Electronic)
IS  - 1350-1925 (Linking)
VI  - 25
IP  - 2
DP  - 2013 Feb
TI  - The addition of pyloroplasty as a new surgical approach to enhance effectiveness 
      of gastric electrical stimulation therapy in patients with gastroparesis.
PG  - 134-e80
LID - 10.1111/nmo.12032 [doi]
AB  - BACKGROUND: Improvement of gastroparesis (GP) symptoms has been documented in 
      patients treated with gastric electrical stimulation (GES), but acceleration of 
      gastric emptying (GET) is unpredictable. The aim of our study was to evaluate the 
      advantage of adding surgical pyloroplasty (PP) to GES for improvement of GET and 
      control of symptoms in diabetes mellitus (DM), idiopathic (ID), and postvagotomy 
      (P-V) GP. METHODS: A total of 49 (17 - DM, 9 - ID, 23 - P-V) consecutive GP 
      patients: 38 female; mean age 42 (21-73 years); mean weight 158 lbs (102-245), 
      underwent GES implantation, and 26 (53%) additionally received PP. Total Symptoms 
      Score, 4-h GET, adverse events (AEs), and days of hospitalizations were captured 
      at baseline and at the last visit. KEY RESULTS: The mean follow-up was 7 months. 
      Total Symptoms Score in patients who received Enterra and PP or GES alone 
      significantly improved compared to their baseline scores (P < 0.001). GET 
      improved by 64% at 4 h (P < 0.001) in patients with Enterra and PP, compared to 
      7% observed after GES therapy alone (ns). The most impressive acceleration of GET 
      was seen in the P-V group, who received both therapies (P = 0.004) and 8 (60%) of 
      them normalized GET. No AEs accompanied the addition of PP to the Enterra 
      surgery. CONCLUSIONS & INFERENCES: (i) In drug-refractory GP the addition of PP 
      to GES substantially accelerated GET; (ii) The GET response in P-V group was the 
      most impressive; (iii) Significant symptom reductions were achieved by both 
      procedures; and (iv) PP added to GES may sustain better long-term symptoms 
      control particularly in the P-V setting.
CI  - (c) 2012 Blackwell Publishing Ltd.
FAU - Sarosiek, I
AU  - Sarosiek I
AD  - Department of Internal Medicine, Texas Tech University Health Sciences Center, El 
      Paso, TX, USA. irene.sarosiek@ttuhsc.edu
FAU - Forster, J
AU  - Forster J
FAU - Lin, Z
AU  - Lin Z
FAU - Cherry, S
AU  - Cherry S
FAU - Sarosiek, J
AU  - Sarosiek J
FAU - McCallum, R
AU  - McCallum R
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20121031
PL  - England
TA  - Neurogastroenterol Motil
JT  - Neurogastroenterology and motility
JID - 9432572
SB  - IM
MH  - Adult
MH  - Aged
MH  - Combined Modality Therapy
MH  - Electric Stimulation Therapy/*methods
MH  - Female
MH  - Gastric Emptying/physiology
MH  - Gastroparesis/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pylorus/*surgery
MH  - Young Adult
EDAT- 2012/11/02 06:00
MHDA- 2013/09/11 06:00
CRDT- 2012/11/02 06:00
PHST- 2012/11/02 06:00 [entrez]
PHST- 2012/11/02 06:00 [pubmed]
PHST- 2013/09/11 06:00 [medline]
AID - 10.1111/nmo.12032 [doi]
PST - ppublish
SO  - Neurogastroenterol Motil. 2013 Feb;25(2):134-e80. doi: 10.1111/nmo.12032. Epub 
      2012 Oct 31.