Combined Role of Gastric Peroral Endoscopic Myotomy and Gastric Electrical Stimulator
Combined Role of Gastric Peroral Endoscopic Myotomy and Gastric Electrical Stimulator in the Management of Refractory Gastroparesis- A Randomized Single Blinded Control Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Texas
-
Dallas, Texas, United States, 75246
- Baylor University Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adult patients of age 18 years and older
- Patients must be able to consent
- Documented diagnosis of refractory GP as determined by the following criteria:
- Medically refractory GP symptoms for > 1 year despite treatment with first-line modalities and pharmacotherapies with anti-emetics and prokinetics AND
- Gastric emptying scintigraphy showing delayed gastric emptying with retention of >60% at 2h and/or greater than 10% at 4h based on standardized radionuclide solid meal test
- Preoperative Gastroparesis Cardinal Symptom Index (GCSI) Score
- A decision to treat patient with surgical therapy of G-POEM and/or electric stimulator
Exclusion Criteria:
- Patients with prior surgical intervention for gastroparesis
- Patients less than 18 years old
- Pregnant women
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Control group
GES off + Upper Endoscopy
|
Participants will receive implantation of a gastric electrical stimulator (GES) with upper endoscopy (which is routine during GES placement), without undergoing G-POEM.
The stimulator will remain off for the first 6 months and will then be turned on for the following 6 months.
|
|
Active Comparator: GES only
GES on + Upper Endoscopy
|
Participants will receive implantation of a gastric electrical stimulator (GES) with upper endoscopy (which is routine during GES placement), without undergoing G-POEM.
The stimulator will stay on for the first 6 months and will then be turned off for the following 6 months.
|
|
Active Comparator: G-POEM only
GES off + GPOEM
|
Participants will receive implantation of a gastric electrical stimulator (GES) with upper endoscopy (which is routine during GES placement) and G-POEM surgery.
The stimulator will remain off for the first 6 months and will then be turned on for the following 6 months.
|
|
Active Comparator: Combination G-POEM and GES
GES on + GPOEM
|
Participants will receive implantation of a gastric electrical stimulator (GES) with upper endoscopy (which is routine during GES placement) and G-POEM.
POEM.
The stimulator will stay on for the first 6 months and will then be turned on for the following 6 months.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Gastroparesis Symptom Changes
Time Frame: Baseline, Preoperative 3 months, 6 months, 9 months, 12 months
|
Monitoring changes in gastroparesis symptom severity as measured by the Gastroparesis Cardinal Symptom Index (GCSI).
A 9-item patient reported questionnaire with a rating scale of 0-5 ranging from 0 (none) to 5 (very severe).
|
Baseline, Preoperative 3 months, 6 months, 9 months, 12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Weight
Time Frame: Baseline, 6 months, 12 months
|
Assessing changes in weight using clinical measurement
|
Baseline, 6 months, 12 months
|
|
BMI
Time Frame: Baseline, 6 months, 12 months
|
Assessing changes in BMI using clinical measurement
|
Baseline, 6 months, 12 months
|
|
Gastroparesis-related hospitalizations
Time Frame: 12 month follow-up
|
Evaluating rates of reintervention/hospitalizations due to surgical complications by referring to subjects medical records
|
12 month follow-up
|
|
ED visits for symptoms
Time Frame: 12 month follow-up
|
Evaluating number of ED visits, hospitalizations/readmissions due to gastroparesis by referring to subjects medical records
|
12 month follow-up
|
|
Gastric Emptying
Time Frame: Baseline, 6 months, 12 months
|
Evaluating gastric emptying as shown in 4-hour retention on gastric emptying scintigraphy using the nuclear medicine report
|
Baseline, 6 months, 12 months
|
|
Antiemetic/Prokinetic use
Time Frame: Baseline, 6 months, 12 months
|
Evaluating changes to pharmacologic use by monitoring active medication use via subjects medical records
|
Baseline, 6 months, 12 months
|
|
Subjects quality of life
Time Frame: Baseline, 6 months, 12 months.
|
Measuring changes to Quality of Life as measured by the 36-Item Short Form Survey (SF-36).
A self-reported tool consisting of 36 questions with a rating scale of 0 (worst health) to 100 (best health).
|
Baseline, 6 months, 12 months.
|
|
Nutritional Support Status
Time Frame: Baseline, 6 months, 12 months
|
Assessing for need for tube feeds/TPN by referring to subjects medical records
|
Baseline, 6 months, 12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Marc Ward, MD, Baylor Health Care System
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neurologic Manifestations
- Digestive System Diseases
- Gastrointestinal Diseases
- Stomach Diseases
- Paralysis
- Pathological Conditions, Signs and Symptoms
- Signs and Symptoms
- Gastroparesis
- Diagnostic Techniques and Procedures
- Diagnosis
- Surgical Procedures, Operative
- Minimally Invasive Surgical Procedures
- Diagnostic Techniques, Surgical
- Endoscopy, Gastrointestinal
- Endoscopy, Digestive System
- Diagnostic Techniques, Digestive System
- Endoscopy
- Digestive System Surgical Procedures
- Gastrectomy
- Myotomy
- Gastroscopy
- Pyloromyotomy
Other Study ID Numbers
Other Study ID Numbers
- 024-238
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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