Page 52 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

Legend: * Some patients experienced multiple minor complications
A total number of 48 reinterventions was required to treat major and minor complications. Fourty-one of these interventions were performed in the operating theater under general anesthesia. The other 7 reinterventions were nasojejunal tube placements under fluoroscopic guidance.
Gastroesophageal reflux
Before LGP, 167 of 289 patients (57.8%) had GER symptoms. After LGP the number of patients with GER was similar (147 of 271 patients; 54.2%; p=0.824; Table 4). Patients without preoperative GER developed postoperative GER symptoms in 34.2%. In 28.2% of patients with preoperative GER, reflux symptoms dissolved after operation.
Table 4. Pre- and postoperative GeR symptoms (n=297).
Legend: NR: Not recorded in patient records
In 180 patients (60%) preoperative 24-hour pH monitoring was completed successfully. Preoperative pathological reflux was present in 32 (17.8%) of these 180. When comparing these patients with a preoperative pathological pH study to the patients with a normal pH study (82.2%), the number of patients with postoperative GER symptoms was evenly distributed (p=0.384). The sensitivity and specificity of preoperative pH monitoring in predicting postoperative reflux symptoms were 17.5% and 76.9% respectively (Table 5).
Table 5. Results of preoperative 24-hour pH-monitoring compared to postoperative reflux complaints
Legend: NR: Not recorded in patient records; Sens: sensitivity; Spec: specificity
Concomitant ARS at the time of LGP was not performed. ARS secondary to LGP was performed in two (0.7%) patients. In both patients the indication for ARS was refractory GER. Only one of these patients underwent 24-hour pH monitoring prior to ARS. However,
Postoperative GeR
no postoperative GeR
Postoperatively NR
Total
Preoperative GeR
107
42
18
167
no preoperative GeR
39
75
8
122
Preoperatively NR
1
7
Total
147
124
297
Preoperative pH monitoring
Postoperative reflux complaints
no postoperative reflux complaints
NR
Pathological reflux
17
15
5
sens=17.5%
Normal pH monitoring
80
50
13
sPeC=76.9%
Failed
5
4
0
No measurement
45
55
11
50