Intraluminal Endosonography for Examination of the Structural Changes of the Stomach in Gastroparetic Patients
Patients who empty their stomach slowly may have what we call "Slow gastric emptying" or "gastroparesis". These patients can have some changes in the thickness of their stomach wall. In addition, they may have loss of some important nerve cells in their stomach muscles. The loss of these cells can cause slow emptying of the stomach. Obtaining a sample from the stomach wall to examine the loss of these cells can help in diagnosing gastroparesis. Up to now, the only way to obtain a tissue sample from the stomach muscle was to undergo an operation in the surgery suite and be hospitalized for several days after the procedure. Usually, we obtain this sample while these patients are having a surgery for another purpose such as placement of a gastric stimulator (a machine which is inserted in the stomach wall to control the stomach rhythm and thus help the stomach to empty faster). Endoscopic ultrasound is an endoscope (a tube with a source of light and ultrasound installed in the tip of the tube) that can measure how thick the stomach wall is and can provide sample "biopsies" of the stomach wall which can be studied for the loss of these specialized muscles and cells.
We are proposing that samples obtained by the endoscopic ultrasound can be sufficient to diagnose "gastroparesis" and can replace the need for obtaining samples by surgery. Endoscopic ultrasound is an outpatient procedure which is not as invasive as surgery.
|Idiopathic Gastroparesis Diabetic Gastroparesis||Procedure: Endoscopic Ultrasound Fine Needle Aspiration (EUS-FNA) Device: 19 guage fine needle aspiration needle|
|Study Design:||Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Diagnostic
- The ability of EUS FNA needle to obtain gastric smooth muscle tissue [ Time Frame: During the procedure ( 45 minutes) ]Wither FNA needle can obtain sufficient muscularis propria tissue from the gastric wall to perform histological staining for the interstitial cell of Cajal and smooth muscles markers. The specimen from the FNA needle will be compared to the standard full thickness gastric biopsy which is routinely obtained in our institution during the surgical placement of the gastric stimulator.
- Safety of EUS FNA of gastric wall ( wither perforation or tear developed after the procedure) [ Time Frame: within 24 hours ]The site of EUS FNA in the stomach wall will be examined surgically for perforations and tear during surgical placement of gastric neurostimulator
|Study Start Date:||March 2013|
|Study Completion Date:||September 2014|
|Primary Completion Date:||September 2014 (Final data collection date for primary outcome measure)|
Experimental: Gastroparetic patient
EUS FNA of the gastric wall prior to surgical placement of gastric neurostimulator
Procedure: Endoscopic Ultrasound Fine Needle Aspiration (EUS-FNA)
After the subjects meet the criteria for enrollment in the study, gastroparetic patients will undergo linear EUS examination of the stomach wall one day prior to their surgery to obtain single or multiple core biopsies of the stomach body wall using the 19-gauge core biopsy needle under EUS guidance. The pathologist will be in the room to assess the adequacy of the sample after each pass. Once the pathologist deemed that the obtained sample is sufficient, the procedure will be terminatedDevice: 19 guage fine needle aspiration needle
Please refer to this study by its ClinicalTrials.gov identifier: NCT01916460
|United States, Texas|
|Texas Tech University HSC at El Paso|
|El Paso, Texas, United States, 79912|