Abstract
BackgroundA gastrostomy placement is frequently performed in pediatric patients who require long-term enteral tube feeding. Unfortunately, postoperative complications such as leakage, feeding intolerance, and gastroesophageal reflux frequently occur. These complications may be due to postoperative gastric dysmotility. Our aim was to evaluate the effect of gastrostomy placement on gastric emptying in children. MethodsA prospective study was performed including 50 children undergoing laparoscopic gastrostomy. Before and 3 months after gastrostomy, assessment was performed using the 13C-octanoic acid breath test, 24-h pH monitoring, and reflux symptom questionnaires. ResultsGastric half-emptying time significantly increased from the 57th to the 79th percentile (p < 0.001) after gastrostomy (p < 0.001). Fifty percent of patients with normal preoperative gastric emptying develop delayed gastric emptying (DGE, P > 95) after gastrostomy (p = 0.01). Most patients (≥75%) with leakage and/or feeding intolerance after gastrostomy had DGE after operation. A decrease in gastric emptying was associated with an increase in esophageal acid exposure time (r = 0.375, p < 0.001). ConclusionGastrostomy placement in children causes a significant delay in gastric emptying. Postoperative DGE was associated with gastroesophageal reflux and was found in most patients with postoperative leakage and feeding intolerance. These negative physiologic effects should be taken into account when considering gastrostomy placement in children.
Highlights
A gastrostomy placement (GP) is frequently performed in pediatric patients to provide prolonged enteral tube feeding
Age and NI were not identified as predictors of postoperative gastric emptying (GE) (Table 6). In this prospective pediatric study, we found that gastrostomy placement causes a significant decrease in GE rate
delayed gastric emptying (DGE) is associated with gastroesophageal reflux (GER), based on the positive correlation between GE-T1⁄2 and acid exposure time, both before and after gastrostomy
Summary
A gastrostomy placement (GP) is frequently performed in pediatric patients to provide prolonged enteral tube feeding. A gastrostomy placement is frequently performed in pediatric patients who require long-term enteral tube feeding. Postoperative complications such as leakage, feeding intolerance, and gastroesophageal reflux frequently occur. Our aim was to evaluate the effect of gastrostomy placement on gastric emptying in children. Postoperative DGE was associated with gastroesophageal reflux and was found in most patients with postoperative leakage and feeding intolerance. These negative physiologic effects should be taken into account when considering gastrostomy placement in children
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