Page 69 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

Figure 2. Gastric emptying before and after GP (n=34)
Legend: GE: gastric emptying; GP: gastrostomy placement; 13C GEBT: 13C-octanoic acid gastric emptying breath test; P: percentile
After dividing the patients into two subgroups: patients with NI and neurologically normal (NN) patients, subanalysis showed that NI patients had a higher GE percentile before operation (P62 (± 36.5) vs P57 (± 36.6)) (Table 3B). The GE percentile in NI patients significantly increased to P84 (± 27.9) after operation (p<0.001), a similar increase compared to the NN patients.
Table 3B. subanalysis of ni patients (n=34)
Legend: 1. Paired T-test. GE: gastric emptying; SD: standard deviation; GEC: gastric evaluation coefficient; GE- T1⁄2: gastric half-emptying time; IQR: interquartile range
sequelae of DGe
A 13CGEBT was completed in 4 out of 6 patients with leakage after gastrostomy, all showing DGE (100%; Fisher’s exact p=0.11). In patients with feeding intolerance, postoperative 13CGEBT showed DGE in 6 out of 8 patients (75%; Fisher’s exact p=0.25).
A positive correlation was found between GE-T1⁄2 and esophageal acid exposure time, both before (r=0.28; p<0.001) and after GP (r=0.46; p<0.001)(n=28). Increased acid exposure time after GP was correlated with increased GE-T1⁄2 (r=0.375; p<0.001). No significant correlation was found between postoperative GE-T1⁄2 and GER symptoms (r=0.016; p=0.624).
Risk factors
In univariable analysis of failure after GP, none of the characteristics examined were statistically significant predictors (Table 4).
Chapter 4
Preoperative 13CGEBT Postoperative 13CGEBT (n=34) (n=34)
Normal GE 26 (76.5%)
GE >P95 8 (23.5%)
13 (50%) 13 (50%)
2 (25%)
6 (75%)
Normal GE 15 (44.1%)
GE >P95 19 (55.9%)
Before GP
After GP
p-value1
GE percentile (SD)
62 (± 36.5)
84 (± 27.9)
0.004
GEC (SD)
3.9 (± 0.95)
3.5 (± 0.69)
0.004
GE-T1⁄2 (minutes; IQR)
44 (27 – 64)
66 (49 – 93)
0.03
67