Page 24 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

ABsTRACT
Introduction: Percutaneous endoscopic gastrostomy (PEG) and laparoscopic gastrostomy placement (LGP) are widely used in the pediatric population. The aim of this study was to determine which of both procedures is the most effective and safe method.
Methods: This systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses statement. Primary outcomes were success rate, efficacy of feeding, quality of life, gastroesophageal reflux and postoperative complications.
Results: After screening 2347 articles, five retrospective studies were identified comparing 550 PEG to 483 LGP in children. The completion rate was similar for both procedures. PEG was associated with significantly more adjacent bowel injuries (p = 0.047), early tube dislodgements (p = 0.02) and complications that require reintervention under general anaesthesia (p < 0.001). Minor complications were equally frequent after both procedures.
Conclusions: Because of the lack of well-designed studies, we have to be cautious in making definitive conclusions comparing PEG to LGP. To decide which type of GP is best practice in pediatric patients, randomized controlled trials comparing PEG to LGP are highly warranted.
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