Temporary percutaneous gastric electrical stimulation: a novel technique tested in patients with non-established indications for gastric electrical stimulation.
OBJECTIVE
To test temporary percutaneous gastric electrical stimulation (TPGES) in patients with drug-refractory nausea/vomiting and nonestablished indications for GES.


METHODS
27 patients (2-81 years) underwent TPGES with electrodes implanted at gastroscopy and received stimulation for 7-21 days with low current settings (5-7 mA) either as open stimulation (n = 14) or randomized to double-blind crossover stimulation (n = 13; ON for 12-14 days, OFF for 12-14 days). Symptoms were recorded daily. Nonresponders were offered another period (14-21 days) with increased stimulation (8-10 mA).


RESULTS
Mean lead implantation time was 14 min. Leads were kept implanted for ≤60 days. 22 of 27 evaluable patients had a favorable symptom reduction, preferentially of nausea/vomiting, irrespective of delayed or normal gastric emptying rate: postsurgical gastroparesis 7/8, chronic intestinal pseudo-obstruction 2/2, idiopathic gastroparesis 1/1, functional dyspepsia 6/9, diabetes mellitus 2/2, postsurgical nausea/vomiting 2/2, malformation syndrome 1/1, intestinal neuropathy 1/1, intestinal interstitial cells of Cajal deficiency 0/1. 6 patients had a clear symptom reduction during the ON period compared with stimulation OFF. Four of 7 patients improved with increased stimulation (8-10 mA). Twenty of the 22 responders received a permanent GES implant, 90% of them still being responders at last follow-up.


CONCLUSIONS
TPGES seems promising to study new indications for GES and to select responders/non-responders.
Andersson
S
S
Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Ringström
G
G
Elfvin
A
A
Simrén
M
M
Lönroth
H
H
Abrahamsson
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000628:therapy*; D018579:Patient Selection; D013270:Stomach; D016896:Treatment Outcome; D014839:Vomiting / Q000628:therapy*; D055815:Young Adult