INTRODUCTION: A gastrostomy placement is frequently performed in pediatric patients who require long-term enteral tube feeding. However, data on efficacy, perioperative complications and postoperative gastroesophageal reflux (GER) after laparoscopic gastrostomy (LAG) placement is limited. The aim of this study is to evaluate long-term efficacy and adverse events after LAG in a large cohort and determine whether routine preoperative 24-h pH monitoring should be used to predict postoperative GER. METHOD: A retrospective observational cohort study was performed including 300 patients (75 % neurologically impaired) that underwent LAG. RESULTS: After a median follow-up of 2.63 years, feeding was successful in 95.9 % of patients. Weight-for-length z-scores significantly increased (p < 0.0005). Major complications were seen in only 6 patients (2.0 %), but minor complications occurred frequently (73.6 %). Overall incidence of GER remained unchanged after LAG. Sensitivity and specificity of preoperative pH monitoring were 17.5 and 76.9 %, respectively. CONCLUSION: LAG placement in pediatric patients leads to successful feeding in 96 % of patients and serious adverse events are rare. However, the minor complication rate is high. Overall incidence of GER does not increase after LAG. Preoperative 24-h pH monitoring is not a reliable tool to predict postoperative GER. This invasive investigation technique should therefore not be routinely performed.
INTRODUCTION: A gastrostomy placement is frequently performed in pediatric patients who require long-term enteral tube feeding. However, data on efficacy, perioperative complications and postoperative gastroesophageal reflux (GER) after laparoscopic gastrostomy (LAG) placement is limited. The aim of this study is to evaluate long-term efficacy and adverse events after LAG in a large cohort and determine whether routine preoperative 24-h pH monitoring should be used to predict postoperative GER. METHOD: A retrospective observational cohort study was performed including 300 patients (75 % neurologically impaired) that underwent LAG. RESULTS: After a median follow-up of 2.63 years, feeding was successful in 95.9 % of patients. Weight-for-length z-scores significantly increased (p < 0.0005). Major complications were seen in only 6 patients (2.0 %), but minor complications occurred frequently (73.6 %). Overall incidence of GER remained unchanged after LAG. Sensitivity and specificity of preoperative pH monitoring were 17.5 and 76.9 %, respectively. CONCLUSION: LAG placement in pediatric patients leads to successful feeding in 96 % of patients and serious adverse events are rare. However, the minor complication rate is high. Overall incidence of GER does not increase after LAG. Preoperative 24-h pH monitoring is not a reliable tool to predict postoperative GER. This invasive investigation technique should therefore not be routinely performed.
Authors: Mohammed Zamakhshary; Mohammad Jamal; Geoffrey K Blair; James J Murphy; Eric M Webber; Erik D Skarsgard Journal: J Pediatr Surg Date: 2005-05 Impact factor: 2.545
Authors: Ester Garne; Joachim Tan; Maria Loane; Silvia Baldacci; Elisa Ballardini; Joanne Brigden; Clara Cavero-Carbonell; Laura García-Villodre; Mika Gissler; Joanne Given; Anna Heino; Sue Jordan; Elizabeth Limb; Amanda Julie Neville; Anke Rissmann; Michele Santoro; Leuan Scanlon; Stine Kjaer Urhoj; Diana G Wellesley; Joan Morris Journal: BMJ Paediatr Open Date: 2022-06
Authors: Ziad Abbassi; Surennaidoo P Naiken; Nicolas C Buchs; Wojciech Staszewicz; Emiliano Giostra; Philippe Morel Journal: Int J Surg Case Rep Date: 2015-06-06
Authors: Louise Roth; Martin Salö; Mette Hambraeus; Pernilla Stenström; Einar Arnbjörnsson Journal: Gastroenterol Res Pract Date: 2015-03-25 Impact factor: 2.260
Authors: Josephine Franken; Femke A Mauritz; Rebecca K Stellato; David C Van der Zee; Maud Y A Van Herwaarden-Lindeboom Journal: J Gastrointest Surg Date: 2017-07 Impact factor: 3.452
Authors: Josephine Franken; Rebecca K Stellato; Stefaan H A J Tytgat; David C van der Zee; Femke A Mauritz; Maud Y A Lindeboom Journal: Qual Life Res Date: 2019-08-16 Impact factor: 4.147