Salameh Jihad R, Aru Giorgio M, Bolton William, Abell Thomas L
Department of Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Ann Thorac Surg. 2008 Apr;85(4):1417-9. doi: 10.1016/j.athoracsur.2007.09.044.
The use of the denervated intrathoracic stomach as esophageal substitute can rarely lead to severe delayed gastric emptying. We describe the use of electrostimulation for this condition.
Gastric electrical stimulation (GES) is used to treat medically refractory gastroparesis and uses a battery powered neurostimulator connected to the gastric antrum with two electrodes. We implant the electrodes through a right thoracotomy and tunnel them to the right subcostal area where the pacemaker is placed.
Medically refractory gastroparesis developed in 2 male patients, aged 52 and 60 years, who underwent Ivor-Lewis esophagectomies for esophageal adenocarcinoma and were dependant on jejunostomy feedings. These patients initially had endoscopic placement of temporary stimulating electrodes with significant improvement in symptoms and radionucleotide gastric emptying. The patients subsequently underwent implantation of a permanent GES device. Relief of symptoms was persistent with no nausea or vomiting and a decrease of total symptom score (maximum 20) from 12.5 and 16 to 6 and 9, respectively.
Patients with intractable delayed gastric emptying after esophagogastrectomy may benefit from a GES device implanted through a thoracotomy.
使用去神经支配的胸内胃作为食管替代物时，很少会导致严重的延迟胃排空。我们描述了针对这种情况使用电刺激的方法。
胃电刺激（GES）用于治疗药物难治性胃轻瘫，它使用一个电池供电的神经刺激器，通过两个电极连接到胃窦。我们通过右胸切开术植入电极，并将其引至放置起搏器的右肋下区域。
两名男性患者，年龄分别为52岁和60岁，因食管腺癌接受了艾弗-刘易斯食管切除术，出现了药物难治性胃轻瘫，依赖空肠造口喂养。这些患者最初在内镜下放置了临时刺激电极，症状和放射性核素胃排空均有显著改善。随后，这些患者接受了永久性GES装置植入。症状持续缓解，无恶心或呕吐，总症状评分（最高20分）分别从12.5分和16分降至6分和9分。
食管胃切除术后顽固性延迟胃排空的患者可能受益于通过胸切开术植入的GES装置。
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