Surgery

Biography

Biography: Dione Lother

Abstract

Introduction: Clinical trials have shown that GES is an effective and safe treatment for intractable nausea and vomiting in adults.  However, less is known about the efficacy and safety of this treatment in the paediatric population.

Objective: We performed a small prospective study to assess the feasibility and effectiveness of GES in children with refractory nausea and vomiting.

Patients: Six children underwent surgical insertion of gastric stimulators for chronic unexplained nausea and vomiting; all were females Median duration of symptoms prior to GES insertion 2.25 years (range 1.25-11years).  Median age at the insertion was 15.5 (range 13-18 years).  Five of 6 patients had proven gastroparesis on gastric emptying studies.  Electrogastrography showed gastric dysrhythmias in all six (increased episodes of tachygastria in 3, bradygastria in 1 and mixed dysrhythmias in 2). None were diabetics.  Surgical approach was via laparotomy in two patients and laparoscopic surgery in the remaining 4 patients (2 robotic-assisted laparoscopic).  

Results: Statistically significant reduction in symptoms (nausea, vomiting, abdominal pain and early satiety) and requirement for nutritional support following GES insertion. There were no peri or immediate/early post-operative complications.

Conclusion: Our study shows GES to be an effective and safe treatment in children with intractable nausea and vomiting.  However, the small sample size is a significant limitation of the study.  Despite this, the results show promise that warrants further investigation of this novel treatment.