Laparoscopic Gastrostomy in Pediatric Oncology Patients

Abstract

Background/Purpose: Long term enteral nutritional support is frequently necessary in pediatric oncology patients because of cancer cachexia, chemotherapy- or radiation-induced mucositis, and other treatment-related toxicity. We report our experience with laparoscopyassisted percutaneous gastrostomies (LAPG). Methods: Fifty consecutive patients with LAPG tube placement were reviewed from January 1999 to April 2003. Results: Thirty-one percent of patients had previously undergone abdominal operations, and 36% were bone marrow transplant recipients. Twenty-six percent had platelet counts less than 80 K/mcL, and 20% had leukocyte counts less than 3 K/mcL. Four patients (8%) were converted to open gastrostomy. Tube feedings began within six hours postoperatively and achieved goal feed within 72 hours. There were no intraoperative complications. Two patients had gastrostomy site infection, and 2 others had tube dislodgement requiring subsequent open gastrostomy. Conclusions: LAPG is a safe and effective method ...