Medical University of South Carolina, Charleston, SC, USA.
Division of Gastroenterology, Hepatology, and Nutrition, University of Louisville, Louisville, KY, USA.
J Gastrointest Surg. 2021 Apr;25(4):1053-1064. doi: 10.1007/s11605-020-04850-w. Epub 2020 Nov 24.
Gastroparesis, which can be viewed as a syndrome featuring nausea, vomiting, and abdominal pain, and associated other symptoms and findings, is increasingly seen by surgeons. Gastroparesis is associated with a number of gastrointestinal anatomic and physiologic findings.
This article reviews the use of bioelectric therapy of neuromodulation, via gastric electrical stimulation, for patients with drug refractory gastroparesis syndromes including surgical aspects of device placement and subsequent management.
In addition to an overall approach to the placement and subsequent management of gastric electrical stimulation devices, several newer concepts are discussed. The role of pyloric dysfunction in gastroparesis is also discussed including how stimulation devices and pyloric therapies may be used in concert. The additions of full-thickness gastrointestinal biopsies along with other physiologic, including GI electrophysiology, as well as some serologic measures, are also discussed. In addition, evolving approaches and emerging technologies for bioelectric neuromodulation of the gastrointestinal tract are introduced.
Gastroparesis syndromes can be approached in a systematic manner based on known pathophysiology and when indicated can be helped with surgical therapies including neuromodulation.
胃轻瘫，可被视为一种以恶心、呕吐和腹痛为特征的综合征，以及与之相关的其他症状和发现，越来越多地被外科医生所关注。胃轻瘫与许多胃肠道解剖和生理发现有关。
本文回顾了生物电疗法中的神经调节，即通过胃电刺激，用于治疗药物难治性胃轻瘫综合征，包括设备放置的手术方面和随后的管理。
除了胃电刺激设备的整体放置和后续管理方法外，还讨论了一些较新的概念。胃轻瘫中幽门功能障碍的作用也包括刺激设备和幽门治疗如何协同使用。还讨论了全层胃肠道活检以及其他生理指标，包括胃肠道电生理学，以及一些血清学指标。此外，还介绍了胃肠道生物电神经调节的新方法和新兴技术。
胃轻瘫综合征可以根据已知的病理生理学进行系统的治疗，当需要时可以通过手术治疗，包括神经调节来帮助缓解。
