Page 49 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

Chapter 3
of neurologic disease (n=23), cystic fibrosis (n=2) and advanced cardiac disease (n=1). The majority of patients (83%) received full feedings within 2 days of LGP. Median postoperative hospital stay was 3 days (IQR 2–4.75).
efficacy
In almost all patients, LGP could be completed laparoscopically. In only 2 patients (0.7 %) conversion to a minilaparotomy was required. In the first patient, intra-abdominal view was compromised by air insufflation of the stomach during intubation. In the second patient, with a history of bronchopulmonary dysplasia and congenital heart disease, abdominal CO2 insufflation led to respiratory problems. To maintain optimal ventilation, the surgeon converted to minilaparotomy.
A summary of feeding methods during long-term follow-up of all available patients is shown in Figure 1. In 34 patients, the method of feeding could not be evaluated because patients had died during follow-up (n=26), the gastrostomy was only used for administering medication (n=3), or no specific feeding method was recorded in the patient records (n=5). Therefore, 266 patients were available for evaluation of feeding method, which was successful in 255 (95.9%) of these patients.
Literature search (June 19th 2012)
Pubmed
n = 1852
Embase
n = 1437
Total: n = 3267
Cochrane
n = 78
Papers retrieved after search:
n = 2347
Potentially relevant for full-text screening:
n = 180
Potentially relevant for more detailed evaluation: n = 11
Included papers:
n =5
• • •
•
Not relevant after full-tekst screening: n = 169
• Domain = adult: n = 2
Only one gastrostomy technique: n = 95 Gastrostomy technique undefined: n = 47 Fluoroscopy guided gastrostomy: n = 11 Determinant is not gastrostomy: n = 5
•
• No seperate outcomes: n = 2 Only technique description: n = 7
Double papers: n = 920
Not relevant after title/abstract screening: n = 2167
Not relevant after detailed screening: n = 6
• Age < 26 years: n = 1
• Selection bias based on patient
characteristics: n = 2
• No report on outcomes of interest: n = 3
Figure 1. Flowchart of patient inclusion
Legend: TPN = total parenteral nutrition
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