Temporary Percutaneous Gastric Electrical Stimulation: A Novel Technique Tested in Patients with Non-Established Indications for Gastric Electrical Stimulation

Aim: 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 a id 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. Conclusion: TPGES seems promising to study new indications for GES and to select responders/non-responders. Copyright (C) 2010 S. Karger AG, Basel