Literature DB >> 23632756

Comparison of percutaneous endoscopic, laparoscopic and open gastrostomy insertion in children.

Ruiwen Liu1, A Jiwane, A Varjavandi, A Kennedy, G Henry, A Dilley, B Currie, S Adams, U Krishnan.   

Abstract

PURPOSE: To compare the outcomes and complications between percutaneous endoscopic gastrostomy (PEG), laparoscopic gastrostomy (LAPG) and open gastrostomy (OG) in children.
METHODS: Retrospective review of 369 patients from July 1998 to December 2010 who had their gastrostomies inserted at a single tertiary paediatric institution. Patients who were lost in follow-up (59) and had insufficient data (23) were excluded from this study. Results were analysed using descriptive statistics.
RESULTS: Of the 369 included in our study, 260 patients underwent LAPG, 86 PEG and 23 open gastrostomy (OG) procedures. The early complication rate for PEGs was 10.5 %, and for LAPGS 2.7 % (p = 0.006). The late complication rate was 41.9 % for PEGs and 43.1 % for LAPGs (p = NS). The overall complication rate for PEG was 54.7 % and it was 44.6 % for LAPG (p = NS). Major complications occurred only in the PEG group: gastro-colonic fistula (1), peritonitis (1), and "buried bumper syndrome" (1). The overall complication rate for OG was 78.3 % (p = 0.01, when this was compared to LAPGs and PEGs together), although there were no early complications in the OG group.
CONCLUSION: PEGs had a significantly higher early complication rate than LAPGs and the only major complications occurred in the PEG group. PEGs also had a higher overall complication rate than LAPGs, although the difference was not statistically significant. Both PEGs and LAPGs were significantly superior to OG in terms of overall complication rates.

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Year:  2013        PMID: 23632756     DOI: 10.1007/s00383-013-3313-9

Source DB:  PubMed          Journal:  Pediatr Surg Int        ISSN: 0179-0358            Impact factor:   1.827


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