No increase in gastroesophageal reflux after laparoscopic gastrostomy in children.

The objective of the study was to assess the influence of a laparoscopic video-assisted gastrostomy on acid gastroesophageal reflux (GER). A prospective uncontrolled study included 23 neurologically disabled children, from 10 months to 15 years of age, all with severe nutritional problems and in need of a gastrostomy. They all had a history of clinical GER problems including vomiting, choking and chest infections. A 24-h pH monitoring was used for a quantitative assessment of GER the day before surgery and 12+/-3 months (7-22 months) postoperatively. The gastrostomy was placed on the anterior wall of the stomach near the lesser curvature. The main outcome measure was the comparison of the pre- and postoperative 24-h pH monitoring and the reflux index (RI), i.e. the percentage of time with pH below 4. The results showed a non-significant reduction of RI from 6.8+/-4.5 preoperatively to 3.7+/-2.0 postoperatively. We conclude that a gastrostomy using the video-assisted technique and placing the stoma on the anterior wall of the stomach close to the lesser curvature does not cause aggravation of acid reflux.