Page 30 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

the colonic perforation. All other perforations were discovered postoperatively after the development of peritonitis, sepsis and/or fecal leakage at the gastrostomy site. All patients with perforations after PEG underwent laparotomy and in one patient a colostomy was needed.
Figure 2: Meta-analysis of adjacent bowel injury after PeG versus LGP.
Legend: Risk ratios are shown in 95% confidence intervals (Mantel–Haenszel random effects model).
Two studies reported data on early tube dislodgement. 16,27 Patients who underwent PEG had a higher risk of early tube dislodgement (RR = 7.44, p = 0.02); Figure 3. All patients with early tube dislodgement in the PEG group needed a reintervention under general anaesthesia to replace the gastrostomy tube. The only patient in the LGP group with early tube dislodgement received a new gastrostomy catheter as an outpatient procedure without any form of anaesthesia required.
The time between initial tube placement and first tube change was mentioned in only two studies and varied between 6 and 8 weeks. 16,17
Figure 3: Meta-analysis of early tube dislodgement after PeG versus LGP.
Legend: Risk ratios are shown with 95% confidence intervals (Mantel–Haenszel random effects model).
Only one article reported on intraperitoneal leakage before the first tube change.17 This study demonstrated similar rates after PEG and LGP (RR = 0.28; p = 0.36). After the first tube change, intraperitoneal leakage was reported in two studies. 16,17 The RR for developing intraperitoneal leakage after tube change after PEG was 3.14 compared to those after LGP. Meta-analysis, did not identify a statistically significant difference (p = 0.28).
28