Çocuklarda Tek Kesi Laparoskopik ve Açık Yaklaşım Gastrostomi Yöntemlerinin Karşılaştırılması

Abstract

Aim: The aim of this study was to compare single incision laparoscopic gastrostomy (SILG) with open surgery in children.
 Material and Methods: Children who underwent laparoscopic and open gastrostomy surgeries between January 2016 and March 2020 were retrospectively evaluated. The data were arranged according to the patient's demographics, duration of surgery and anesthesia, time to start enteral feeding, and complications. For Stamm procedure, the abdomen was explored with an upper midline incision and a gastric tube was passed through a second incision. In the SILG method, only one incision was made. After inserting a camera was placed into a trocar, then a grasper was placed just next to the trocar. A part of stomach was removed through the incision. A foley catheter was placed visually into the lumen.
 Results: There was no statistically significant difference between operation times for both surgical groups (p=0.844); the same was true for anesthesia times (p=0.919). The time taken to initiate and reach full enteral nutrition differed significantly between two groups (p=0.005). In general, when all complications were evaluated, more complications were found in the open surgery group (p=0.077). A remarkable number of maintenance problems (65.6%) were observed in both groups.
 Conclusion: SILG is a technique that is not technically demanding and can be performed by any pediatric surgeon with experience in laparoscopy. Primary laparoscopic gastrostomy at the trocar insertion site can be performed easily and safely in all children with malnutrition due to low postoperative complication rates and applicable for all ages of children.