Abstract

BackgroundWith gastrostomy becoming a common surgical procedure within the pediatric population surgeons continued to introduce modifications on the procedure to overcome some of the challenges and minimize complications. Modified U-stitches laparoscopic gastrostomy is gaining favor in some centers including the center of this study. Hence, this study was conducted to evaluate and compare its outcomes.MethodsEighty-nine gastrostomy procedures performed between 2013 and 2020 were reviewed to evaluate the surgical outcomes of a novel modified U-stitches laparoscopic gastrostomy (MLG) to the standard laparoscopic gastrostomy (LG) in children. The main outcome measured is the rate of postoperative complications encompassing dislodgement of gastrostomy button, leak around button, local infection, and development of granulation tissue post-surgery which is compared between the two population groups.ResultsThe rate of leak around the button was found to be significantly less in the MLG (4%) compared to (15%) in the traditional LG approach with a p-value of 0.03. However, the overall complication rate for MGL is 63%; while it is 73% for LG.ConclusionsThe modified U-stitches laparoscopic gastrostomy has a lower rate of complications in comparison to the standard laparoscopic gastrostomy making it a preferred technique for gastrostomy placement in children.

Highlights

  • With gastrostomy becoming a common surgical procedure within the pediatric population surgeons continued to introduce modifications on the procedure to overcome some of the challenges and minimize complications

  • According to the European Society for Clinical Nutrition and Metabolism (ESPEN), gastrostomy tube is indicated in patients who require enteral feeding for more than 2 weeks [1]

  • A total number of 89 children were enrolled in the study

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Summary

Introduction

With gastrostomy becoming a common surgical procedure within the pediatric population surgeons continued to introduce modifications on the procedure to overcome some of the challenges and minimize complications. According to the European Society for Clinical Nutrition and Metabolism (ESPEN), gastrostomy tube is indicated in patients who require enteral feeding for more than 2 weeks [1]. The goal of this feeding supplementation is to prevent significant weight loss, nutritional deficiencies, assist with growth in children and improve their quality of life. While all methods have varying complications, surgeons are continuously trying to evaluate and choose the appropriate method to improve patient outcome and minimize complications [3,4,5]. With the continuous advances in laparoscopy, laparoscopic gastrostomy (LG) became

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