Cleveland Clinic, Bariatric and Metabolic Institute, Cleveland, OH 44195, USA.
J Gastrointest Surg. 2013 Mar;17(3):461-70. doi: 10.1007/s11605-012-2128-7. Epub 2013 Jan 4.
Gastric electrical stimulator (GES) implantation is effective in certain patients with gastroparesis; however, laparotomy is often employed for placement. The aim of this study is to review outcomes of patients who underwent laparoscopic GES therapy for diabetic and idiopathic gastroparesis at a large referral center.
Patients who underwent GES (Enterra Therapy System; Medtronic, Minneapolis, MN) implantation with subsequent interrogation and programming between March 2001 and November 2011 were analyzed.
A total of 113 patients underwent GES placement or revision during the study period. One hundred eleven patients underwent primary GES at our institution, while two patients underwent GES generator revision at our institution. Primary operations were completed laparoscopically in 110 of 111 cases, with one conversion to laparotomy due to severe adhesions. At a mean follow-up of 27 months (1-113), symptom improvement was achieved in 91 patients (80 %) and was similar for both the diabetic and idiopathic subgroups. Need for supplemental nutrition (enteral and/or parental) decreased in both groups.
GES placement is feasible using a laparoscopic approach. Medical refractory gastroparesis in the diabetic and idiopathic groups had significant symptom improvement with no difference between the two groups. Need for supplemental nutrition is decreased following GES.
胃电刺激器（GES）植入术对某些胃轻瘫患者有效；然而，通常采用剖腹手术进行放置。本研究旨在回顾在大型转诊中心接受腹腔镜 GES 治疗的糖尿病和特发性胃轻瘫患者的结局。
分析了 2001 年 3 月至 2011 年 11 月期间接受 GES（Enterra 治疗系统；美敦力，明尼苏达州明尼阿波利斯）植入并随后进行询问和编程的患者。
在研究期间，共有 113 例患者接受了 GES 放置或修正。111 例患者在我们机构接受了原发性 GES，而 2 例患者在我们机构接受了 GES 发生器修正。110 例原发性手术均在腹腔镜下完成，1 例因严重粘连而转为剖腹手术。在平均 27 个月（1-113）的随访中，91 例患者（80%）症状得到改善，糖尿病组和特发性组相似。两组患者的补充营养（肠内和/或肠外）需求均减少。
使用腹腔镜方法可以实现 GES 放置。糖尿病和特发性两组患者的医学难治性胃轻瘫症状均有显著改善，两组之间无差异。GES 后补充营养的需求减少。
