Page 48 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

intervention, nonclosure of the gastrostomy after removal of the catheter, catheter size mismatch, gastroparesis, dumping syndrome and the development of crustaceous eczema at the gastrostomy site.
Reinterventions
Reinterventions were defined as all adverse events after LGP requiring an intervention in the operating theater or at the radiology department.
Gastroesophageal reflux
GER symptoms before and after LGP and the need for concomitant and/or secondary ARS were evaluated. Symptoms of persistent vomiting, frequent aspiration, heartburn and/or regurgitation were used to define GER. Preoperative 24-hour pH monitoring was performed in 189 of all 300 patients. In 180 patients (60%) preoperative 24-hour pH monitoring was successful and in 9 patients it had failed due to incorrect placement of the pH probe or dislocation of the probe during the measurement.
Pathological acid exposure was defined as total acid exposure time >6%, or >3% in upright and >9% in supine body position. 18,19
statistical analysis
The efficacy of LGP was analyzed using only the patients who underwent LGP for long- term enteral feeding. Patients who underwent LGP for administering medication were only included in the analysis of adverse events.
Continuous variables, when parametric, were expressed as mean ± standard error of the mean (SEM). Non-parametric variables were expressed as median, with interquartile ranges (IQR). For continuous parametric outcomes a paired sample T-test was performed. Non-parametric continuous outcomes were analyzed using the Wilcoxon signed-rank test. The Chi squared test was used to analyze dichotomous outcomes. In case dichotomous outcomes were repeated measures the McNemar’s test was used. Additionally, sensitivity and specificity of preoperative 24-hour pH monitoring on predicting postoperative GER symptoms were calculated. Differences with a p<0.05 were considered statistically significant. All analyses were performed using SPSS statistical package (IBM, USA).
ResULTs
Median follow-up time was 2.63 years (IQR 1.07–4.77). During follow-up, twenty-six patients (8.7%) had died of causes unrelated to LGP. Causes of death were deterioration
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