Walaa F Abdelmoaty, MD, MBA1, Christy M Dunst, MD, FACS2, Ahmed M Zihni, MD, MPH1, Filippo Filicori, MD1, Daniel Davila Bradley, MD2, Kevin M Reavis, MD, FACS2, Steven R DeMeester, MD, FACS2, Lee L Swanstrom, MD, FACS2. 1Providence Portland Medical Center, 2The Oregon Clinic
Introduction: Gastroparesis (GP) is a chronic, debilitating disease that presents with nausea, vomiting, abdominal pain and gas bloat in the setting of delayed gastric emptying without mechanical obstruction. Treatment goals are symptom control and maintenance of nutrition through medical, dietary and surgical therapies. Previously, we reported that minimally invasive pyloroplasty significantly improved patients’ symptoms on short-term follow up. The aim of this study is to report the long-term course and outcomes for the same cohort.
Methods and procedures: The 28 patients, who formed the previously published cohort, were contacted and their charts were reviewed. Follow-up visits, symptom severity scores, and any subsequent medical or surgical interventions were collected. Symptoms were assessed using the symptom severity score (SSS) and the gastroparesis cardinal symptom index (GCSI) questionnaires. Success was defined as a SSS of 2 or less.
Results: Out of 28 original patients, 15 patients (2 males, 13 females) were available for follow-up (2 patients declined participation, 9 were lost to follow-up, 1 patient was deceased, and 1 was excluded after undergoing esophagectomy for unrelated indication). At a median follow-up of 115 months the initial improvements were stable for a majority of patients. Successful palliation of symptoms was seen in 80% for vomiting, and in 67% for nausea, abdominal pain, and gas bloat. Median total GCSI score was 15 (mild). Only 1 (7%) patient still uses a prokinetic medication. A total of 11 adjunct GP treatment interventions were recorded in 6 patients (40%): (4 percutaneous endoscopic gastrostomy tube (PEG), 3 jejunostomy tube (J-tube), and 4 Gastric stimulator implantation) at some point of their follow-up.
Conclusion: Initial palliation of symptoms is stable 10 years following pyloroplasty for gastroparesis. The majority of patients do not require adjunctive surgical interventions. Contemporary algorithms for treatment of gastroparesis should include early surgical intervention.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87905
Program Number: P671
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster