Page 44 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

ABsTRACT
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 placement (LGP) is limited. The aim of this study is to evaluate long-term efficacy and adverse events after LGP in a large cohort and determine whether routine preoperative 24-hour pH monitoring should be used to predict postoperative GER.
Methods: A retrospective observational cohort study was performed including 300 patients (75% neurologically impaired) that underwent LGP.
Results: After a median follow-up of 2.63 years, feeding was successful in 95.9 % of patients. Weight-for-height z-scores significantly increased (p<0.0005). Major complications were seen in only 6 patients (2.0%), but minor complications occurred frequently (73.6%). The overall incidence of GER remained unchanged after LGP. Sensitivity and specificity of preoperative pH monitoring were 17.5 and 76.9%, respectively.
Conclusion: LGP 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 LGP. Preoperative 24-hour pH monitoring is not a reliable tool to predict postoperative GER. This invasive investigation technique should therefore not be routinely performed.
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