Saleem Islam1, Jillian McLaughlin2, Justine Pierson3, Christopher Jolley4, Archana Kedar5, Thomas Abell6. 1. Division of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, Gainesville, FL, United States. Electronic address: saleem.islam@surgery.ufl.edu. 2. Division of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, Gainesville, FL, United States. 3. Division of Plastic Surgery, Department of Surgery, University of Florida College of Medicine, Gainesville, FL, United States. 4. Division of Pediatric Gastroenterology, Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, United States. 5. Internal Medicine, University of Mississippi Medical Center, Jackson, MS, United States. 6. Division of Gastroenterology, Department of Medicine, University of Louisville, Louisville, KY, United States.
Abstract
BACKGROUND: Gastric electrical stimulation (GES) has been used in adults with gastroparesis. However its use has been limited in children. We describe the largest experience with GES in children with long-term outcomes. METHODS: Data were collected on children who underwent GES over a 10-year period. Data regarding demographics, medical history, hospital course, and outcomes were collected and analyzed. Symptom scores (validated Likert scores) were compared using a paired Student's t test. RESULTS: Overall, 97 patients underwent GES, and a majority were teenage Caucasian girls. Ninety-six had temporary GES (tGES), and 66 had improvement in their symptoms. A total of 67 underwent permanent implantation (pGES), and there was significant reduction in all individual symptoms (p<0.001) as well as the total symptom score (TSS) (p<0.0001) at 1, 6, 12, and >12 months. Recurrence of symptoms leading to device removal occurred in 7 cases. Forty-one patients had continued improvement in symptoms for over 12 months, with a mean follow-up of 3.5 years (range 1-9 years). CONCLUSIONS: This study represents the largest experience of systematic application of GES in children. GES is a safe and effective therapy for selected children with intractable GP with continued symptomatic improvement at 1 year and beyond.
BACKGROUND: Gastric electrical stimulation (GES) has been used in adults with gastroparesis. However its use has been limited in children. We describe the largest experience with GES in children with long-term outcomes. METHODS: Data were collected on children who underwent GES over a 10-year period. Data regarding demographics, medical history, hospital course, and outcomes were collected and analyzed. Symptom scores (validated Likert scores) were compared using a paired Student's t test. RESULTS: Overall, 97 patients underwent GES, and a majority were teenage Caucasian girls. Ninety-six had temporary GES (tGES), and 66 had improvement in their symptoms. A total of 67 underwent permanent implantation (pGES), and there was significant reduction in all individual symptoms (p<0.001) as well as the total symptom score (TSS) (p<0.0001) at 1, 6, 12, and >12 months. Recurrence of symptoms leading to device removal occurred in 7 cases. Forty-one patients had continued improvement in symptoms for over 12 months, with a mean follow-up of 3.5 years (range 1-9 years). CONCLUSIONS: This study represents the largest experience of systematic application of GES in children. GES is a safe and effective therapy for selected children with intractable GP with continued symptomatic improvement at 1 year and beyond.