Page 78 - Effects and Efficacy of (Laparoscopic) Gastrostomy Placement in Children - Josephine Franken

ABsTRACT
Introduction: A gastrostomy placement (GP) is frequently performed in pediatric patients who require long-term enteral tube feeding. Current evidence on the relation between GP and the development of postoperative gastroesophageal reflux has been inconsistent. The aim of this study is to investigate the influence of GP on GER with 24-hour multichannel intraluminal impedance pH monitoring (MII-pH monitoring).
Methods: A prospective, longitudinal cohort study was performed including 50 patients who underwent laparoscopic GP between May 2012 and April 2014. Caregivers filled out GER symptom questionnaires and 24-hour MII-pH monitoring was performed before and 3 months after surgery.
Results: Twenty-five out of 50 included patients (50%) underwent both the preoperative and postoperative tests and were included in MII-pH analysis. Total acid exposure (percentage of time with pH below 4) did not change significantly after GP: from 6.2% (3.0 – 18.1) to 6.1% (2.6 – 14.9). The number of reflux episodes did not significantly change, for either liquid (mean difference 4.3 (-4.5 – 13.2)) or mixed liquid-gas reflux (mean difference 2.0 (-9.3 – 13.3)). Before GP, 18 out of 25 patients had pathological GER (72%). This percentage of patients did not change after GP (72%): In four patients pathological GER dissolved, whereas four patients newly developed pathological GER. A low preoperative weight-for-height percentile was associated with increased acid exposure after GP.
Conclusion: Overall, GP did not induce GER in children.
76