Page 70 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

Table 4. Predictors of gastrostomy failure – univariable analysis (n=50)
Predictors (preoperative)
p-value
Predictive value (odds)
95% Ci
Age (years)
0.11
0.84
0.67
-
1.05
Acid exposure time (% / 24h)
0.17
0.93
0.85
-
1.03
Neurologic impairment (yes/ no)
0.18
0.44
0.11
-
1.54
GE (percentile)
0.27
0.99
0.97
-
1.01
Symptomatic GER (GSQ)
0.50
1.01
0.98
-
1.04
Legend: GE: gastric emptying; CI: confidence interval; GER: gastroesopheal reflux; GSQ: gastroesophageal reflux symptom questionnaire
In multivariable analysis of postoperative GE, only the preoperative GE was a positive predictor (B=0.3; 0.04–0.6). Age and NI were not predictive of postoperative GE (Table 5).
Table 5. Predictors of postoperative Ge percentile – multivariable analysis (n=50)
Legend: GE: gastric emptying; CI: confidence interval
DisCUssion
In this prospective pediatric study, we found that gastrostomy placement causes a significant decrease in GE rate. Fifty percent of patients with a normal preoperative GE develop DGE after GP.
This is the first prospective study on GE before and after GP involving pediatric patients. Only one previous study was published on this subject. 11 This was a retrospective study including 26 NI children undergoing laparoscopic GP. In contrast to our study, authors reported no significant changes in GE after operation. This might be due to the shorter follow-up time in that study of 6-13 days after surgery.
In adults, two studies have been performed on GE after GP, showing no significant changes. The first study reported a non-significant delay in GE-T1⁄2 in 11 patients. 9 The second study found that GE was unaffected after GP. 10 GE testing in this study was, however, conducted with the paracetamol absorption test, i.e. plasma concentrations of
Predictors
p-value
Predictive value (B)
95% Ci
Preoperative GE (percentile)
0.03
+0.3
+0.04
-
+0.6
Neurologic impairment (yes/ no)
0.32
+9.8
-9.5
-
+29.2
Age (years)
0.71
+0.5
-2.0
-
+3.0
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