title: Temporary percutaneous and permanent gastric electrical stimulation in children younger than 3 years with chronic vomiting.
abstract: BACKGROUND
  The aim was to investigate whether young children with drug-refractory nausea and vomiting can be treated with gastric electrical stimulation (GES) in a similar way as adults and to evaluate whether temporary percutaneous gastric electrical stimulation (TPGES) can be used in the pediatric population to select the patients who are responders to GES treatment. We report the clinical results in 3 children between 2 and 3 years of age. To the best of our knowledge, these are the youngest patients treated with GES.
  
  
  METHODS
  Three patients younger than 3 years with intractable vomiting underwent TPGES. Custom-made leads were percutaneously implanted in the gastric wall under gastroscopic guidance. Symptoms were recorded daily during the TPGES stimulation time (12-40 days). Responders were offered permanent GES treatment.
  
  
  RESULTS
  There were no technical problems. All 3 patients were responders to TPGES. They are now treated with surgically implanted permanent GES and reported greater than 50% vomiting reduction at last visit.
  
  
  CONCLUSIONS
  Children younger than 3 years can be treated with GES in a similar way as adolescents and adults. Temporary percutaneous GES is a safe, feasible technique even in small children, with the possibility to perform the test over several weeks to select responders to GES treatment.
authors.affiliation: Department of Pediatrics, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 416 85 Gothenburg, Sweden. Electronic address: anders.elfvin@vgregion.se.
authors.forename: Anders
authors.initials: A
authors.lastname: Elfvin
authors.affiliation: Department of Pediatric Surgery, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 416 85 Gothenburg, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Göthberg
authors.affiliation: Department of Surgery, Sahlgrenska University Hospital, 416 85 Gothenburg, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Lönroth
authors.affiliation: Department of Pediatrics, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 416 85 Gothenburg, Sweden.
authors.forename: Robert
authors.initials: R
authors.lastname: Saalman
authors.affiliation: Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Hasse
authors.initials: H
authors.lastname: Abrahamsson
mesh_terms: D002675:Child, Preschool; D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying; D018589:Gastroparesis / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014839:Vomiting / Q000209:etiology / Q000628:therapy*