22, 1.62]; P < 0.00001) in a fixed-effect model, and the mean difference of NSS was 1.47 (95% CI: [1.82, 2.11]; P < 0.00001) in a random-effect model. Solid gastric emptying was increased in patients with gatroparesis. Six of the studies (n = 380) reported gastric emptying at 2 h after standard testing by solid meal ingestion (Fig. 2a), and seven other studies (n = 408) reported gastric emptying at 4 h (Fig. 2b). In the comparison to baseline,
the summary of both 2 h (mean difference: FG-4592 cost 22.6%, 95% CI: [11.82, 33.37]; P < 0.0001) and 4-h gastric retention (mean difference: 13.04%, 95% CI: [7.44, 18.64]; P < 0.00001) in a random-effect model demonstrated highly-significant improvements after GES. Subanalysis: high-frequency GES to DG, IG, and PSG. The three most common gastroparesis etiologies are DG, IG, and PSG. Five of the studies treated DG (n = 197) (Fig. 3, Table 2). Post-GES measures demonstrated a consistent and significant benefit over baseline measures for both TSS (n = 180) (P < 0.00001, random-effect model) and gastric emptying (n = 137)
(2-h gastric retention [P = 0.003, random-effect model] and 4-h gastric retention [P = 0.0001, random-effect model]). Three publications involved IG (n = 65) (Fig. 4, Table 2). TSS (P < 0.00001, fixed effect model) and 4-h gastric retention (P = 0.0005, fixed-effect model) improved significantly after GES, but gastric retention at 2 h (P = 0.18, random-effect model) did not reach significance. For the etiology of PSG, 40 were patients analyzed (Fig. 5, Table 2). TSS (P < 0.00001, fixed-effect model) and 2-h gastric retention (P < 0.00001, fixed-effect model) improved significantly after GES, while gastric retention LY2157299 at 4 h (P = 0.23, random-effect
model) did not reach significance. Complications of high-frequency GES. Eight (n = 595) of the nine studies reported complications. The three most common complications were infection (3.87%), lead or device migration (2.69%), and pain at the implantation site (0.67%). IMP dehydrogenase A small number of patients (1.18%) also had complications of peptic ulcer disease, penetration of the electrode into the lumen of the stomach, skin erosion after abdominal wall trauma, small bowel obstruction caused by the wires and so on. Generally speaking, high-frequency GES is a relatively safe method for treating gastroparesis. High-frequency GES is a new therapeutic method for patients with medically-refractory gastroparesis. In our research, we assessed the effects of high-frequency GES on the TSS, VSS, NSS, and gastric emptying at 2 h and 4 h using a meta-analysis methodology, concluding that high-frequency GES not only significantly benefited in the improvement of symptoms, but also improved 2-h and 4-h gastric emptying for gastroparesis patients. A subanalysis was then carried out to evaluate the effects of high-frequency GES on DG, IG, and PSG patients, which suggested that DG patients were the most responsive to high-frequency GES.