Five-Year Sustained Durability of Clinical Response After Gastric Electrical Stimulation Therapy (GES) for Severe Gastroparesis: 177

Introduction: Gastroparesis patients suffer from chronic nausea, vomiting, and malnutrition. Data on long-term clinical response after GES therapy is sparse. Our objective was to determine the symptom response and nutritional outcome after 3 and 5 years of GES therapy in patients with medically refractory gastroparesis. Methods: Twelve patients with gastroparesis and GES implantation between March 2007 and March 2009 were reviewed. Symptom response was assessed using a modified Gastroparesis Cardinal Symptom Index (GCSI) on a Likert scale from 0-4 that inquired about nausea, vomiting, early satiety, bloating, and post-prandial fullness. Symptom sub scores, entral nutrition, and need for hospitalization were also evaluated. Results: Twelve patients (67% females, 75% white, mean age 42 years) had high-energy, low-frequency GES for 5 years. Etiology: 5 idiopathic, 7 diabetic (type 1DM=3, type 2 DM=4). The GCSI decreased from a baseline of 2.59 to 1.76 (p=0.12) at 3 years and 1.58 (p=0.11) at 5 years, respectively. There was significant reduction in symptom severity and frequency of vomiting and nausea at 3 and 5 years (Table 1 and Table 2), respectively. The need for hospitalization decreased from 5/12 (42%) patients at baseline to 2/12 (17%) patients at 3 and 5 years. Mean BMI increased from 24.54 at baseline to 25.69 (p=0.13) at 5 years. At baseline, 8/12 patients (75%) required enteral nutrition. Only 3 (25%) required a feeding tube at 5 years.Table 1: Symptom Severity in Gastroparesis Patients at 3 and 5 Years After GESTable 2: Symptom Frequency in Gastroparesis Patients at 3 and 5 Years After GESConclusion: Long-term significant improvement in nausea, vomiting, and nutritional parameters is seen at 5 years after GES therapy in patients with medically refractory gastroparesis.