Severe gastro-oesophageal reflux necessitating fundoplication after percutaneous endoscopic and open gastrostomy in children

Abstract

The three major techniques for a gastrostomy in children are open gastrostomy (OG), percutaneous endoscopic gastrostomy (PEG) and laparoscopic-assisted gastrostomy. Here, we have evaluated the outcome after OG and PEG in 69 children operated in Kuopio University Hospital. The medical records of 69 consecutive children who had either PEG (n = 56) or OG (n = 13) over an 18-year period (1990-2008) were reviewed. There was no difference between the PEG- and OG-groups in the patients' characteristics, indications for tube placement and hospital stay. The mean procedure time was 43 min shorter in the PEG-group (28 ± 38 min) than in the OG-group (71 ± 58 min) (P = 0.003). Four children (8%) in the PEG-group and one (8%) in the OG-group required later surgical interventions related to gastrostomy. Severe gastro-oesophageal reflux (GER) necessitating fundoplication was detected in 15 children (27%) in the PEG-group and in 7 children (54%) in the OG-group (P = 0.06). The results of this study indicated a higher incidence for severe GER leading to fundoplication in children with OG, while no difference with complications and clinical outcome between the two techniques, OG and PEG, were observed.