Gastric electrical stimulation versus standard medical therapies for long-term symptom control and improved quality of life in drug-refractory gastroparesis patients.

OBJECTIVES

This systematic review and meta-analysis evaluated the effectiveness of gastric electrical stimulation (GES) in alleviating symptoms of gastroparesis (GP) compared to alternative medical therapies.

METHODS

We conducted a comprehensive search of PubMed, Cochrane Library, and Embase from January 2004 to October 2024 using MeSH terms and keywords related to GP and GES. The search included randomized controlled trials (RCTs) and observational studies published in English. Data extraction followed PRISMA and AMSTAR guidelines. The primary outcome was symptom control, measured using the weighted mean difference and a 95% confidence interval (CI). Statistical analysis was performed using RevMan software, and the certainty of evidence was assessed using the GRADE tool.

RESULTS

A total of 1918 articles were screened, with 4 studies included in the final analysis. The mean difference in symptom control was -0.16 (95% CI: -0.57, 0.26). Heterogeneity was assessed using the chi-square Test, and inconsistency was quantified using the I2 index.

CONCLUSIONS

GES provides some symptomatic relief in GP, particularly for nausea and vomiting, though the improvements were not statistically significant. Future research should focus on non-crossover RCTs to minimize bias and further explore GES efficacy in idiopathic and postsurgical gastroparesis cases.