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Canadian Journal of Gastroenterology and Hepatology - Volume 29 2015, Issue 4, Pages 198-202

Original Article

Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

Division of General Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

Received 20 January 2015; Accepted 25 January 2015

Copyright © 2015 Hindawi Publishing Corporation. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License CC BY-NC http:-creativecommons.org-licenses-by-nc-4.0-, which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.

Abstract

BACKGROUND: The efficacy of gastric neurostimulation therapy for diabetic gastroparesis GP in a ‘real-life’ Canadian setting has not been assessed.

AIMS: To assess changes in health-related quality of life QoL, weekly vomiting frequency WVF, total symptom score TSS and health care utilization 12 months before and after gastric neurostimulator implantation in a diabetic GP cohort.

METHODS: Medication-refractory diabetic GP patients n=7, four female, mean age 42 years were prospectively recruited from 2008 to 2012. QoL scores were self-administered and obtained at baseline, 24 and 48 weeks postimplantion. WVF and TSS were assessed similarly. Health care usage, measured as hospitalization frequency and medication cost, was obtained six and 12 months before and after implant. Changes from baseline to six and 12 months for all outcomes were compared.

RESULTS: The mean ± SD QoL according to EuroQol was significantly better at 24 weeks after the baseline measurement baseline 29±5, 24 weeks 52±7; P=0.03. The mean improvement in TSS was significantly better at one year postintervention baseline score 35±5 versus 12 months 27±3; P=0.03. Changes in Short-Form 36 Health Survey and WVF were not significant. Days of GP-related hospitalization were highly variable but decreased from a median of 71 days range 0 to 227 days to 29 days range two to 334 days one year before and after surgery, respectively P=0.735. Outpatient medication costs did not decrease to a significant extent.

CONCLUSION: Gastric neurostimulation for diabetic GP appeared to show some beneficial palliative effects overall in the present small open-label series, but the effect is highly variable among patients, and placebo effect cannot be ruled out.





Autor: Himanish Panda, Philip Mitchell, Michael Curley, Michelle Buresi, Lynn Wilsack, and Christopher N Andrews

Fuente: https://www.hindawi.com/



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