Endoscopic pyloric injection of botulinum toxin A for the treatment of refractory gastroparesis
| Autor: | Kenneth Swartz, Frank K. Friedenberg, Larry S. Miller, Matthew Q. Bromer, Henry P. Parkman, Robert S. Fisher |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Gastroparesis Time Factors Adolescent Vomiting Gastroenterology Injections Sex Factors Refractory Interquartile range Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Endoscopy Digestive System Botulinum Toxins Type A Pylorus Aged Retrospective Studies business.industry Remission Induction Nausea Retrospective cohort study Middle Aged medicine.disease Botulinum toxin Abdominal Pain Surgery Treatment Outcome medicine.anatomical_structure Gastric Emptying Neuromuscular Agents Sphincter Female medicine.symptom business Follow-Up Studies medicine.drug |
| Zdroj: | Gastrointestinal Endoscopy. 61:833-839 |
| ISSN: | 0016-5107 |
| DOI: | 10.1016/s0016-5107(05)00328-7 |
| Popis: | Background Botulinum toxin A injected into the pyloric sphincter has been reported in small case series to treat gastroparesis. This study reviews the use of this treatment in a large number of patients with gastroparesis. Methods Patients who underwent pyloric botulinum injection for treatment of gastroparesis were identified. Response was defined as improvement or resolution of the patient's major symptom and/or two minor symptoms for 4 weeks. Results Of 115 patients treated, 63 patients met the study criteria. There were 53 women, 10 men, mean age 42 years. Most patients (56%) had idiopathic gastroparesis. Twenty-seven of 63 (43%) patients experienced a symptomatic response to treatment. By stepwise logistic regression, male gender was associated with response to treatment (OR 3.27: 95% CI[1.31, 8.13], p =0.01). Vomiting as a major symptom was associated with a lack of response (OR 0.16: 95% CI[0.04, 0.67], p =0.01). Despite the association of male gender with response, the mean duration of response for those patients responding, with a minimum of 3 months' follow-up was 4.9 months (±2.7 months) for women and 3.5 months (±0.71 months) for men ( p =0.59). The corresponding medians and interquartile ranges (IQR) were 5 (IQR 3-6) for females and 3.5 (IQR 3-4) for males. Conclusions Of the patients, 43% had a response to botulinum toxin treatment that lasted a mean of approximately 5 months. Male gender was associated with a response to this therapy; however, durability of response was unrelated to gender. Vomiting as a major symptom predicted no response. |
| Databáze: | OpenAIRE |
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