Page 46 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

adverse events of LGP in a large cohort and to determine the value of routine preoperative 24-hour pH monitoring for predicting postoperative GER after LGP.
MeTHoDs
study design
A retrospective observational cohort study including all patients that underwent LGP in the Wilhelmina Children’s Hospital between January 2004 and December 2011 was performed. The medical records of all patients were retrospectively reviewed using the electronic medical record. All clinical data were recorded in a database.
Table 1. Patient characteristics
Legend: iQR: interquartiale range, n: number
Participants
A total of 300 patients with a median age of 2.66 years (IQR 1.28–7.44) were included. Patient characteristics are described in Table 1. Indications for LGP were inability to obtain adequate nutrition (99.0%) orally, which resulted in failure to thrive and/or growth retardation.
In 3 patients (1.0%) indication for LGP was to guarantee a safe route for administering medication. The main underlying diseases were neurological disorders (75.0%) and cystic fibrosis (9.7%). Neurological impairment was mostly manifested as psychomotor retardation, epilepsy, microcephaly, spasticity, visual impairment and/or hypotonia.
surgical procedure
All children underwent LGP under general anesthesia. All procedures were performed or supervised by an experienced pediatric surgeon. An infra-umbilical 6 mm trocar was introduced for the camera. Between the umbilicus and the costal margin, a small incision was made through which a Babcock clamp was introduced to grasp the lateral wall of the corpus under direct laparoscopic view. This part of the stomach was then sutured to
Demographics
Total number of patients
300
Median (years)
Age at time of operation
2.66 (IQR 1.28 – 7.44)
Follow-up time
2.63 (IQR 1.07 – 4.77)
n (%)
Male gender
158 (52.7%)
Neurologically impaired development
225 (75.0%)
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