Does the placement of a FRECA gastrostomy at the time of laparoscopic fundoplication impact on outcome?

Abstract

FP placement at the time of laparoscopic fundoplication does not appear to compromise the outcome of surgery. Neither the size of patient nor the type of wrap is an impediment to its placement and the device can be used shortly after surgery in the majority allowing for an early discharge. Complications are infrequent; however, change to a button device within 2 years of initial placement requires general anaesthetic.

Does Gastrostomy Placement With Concurrent Fundoplication Increase the Risk of Gastrostomy‐related Complications?

“…For this reason, most gastrostomy patients in this study received a PEG. According to present paediatric literature, the proportion of children requiring gastrostomy insertion that are NI varies between 41% and 73% (1,2,5,6,8,9,10,11). The large number of NI children in this study (72.4%) requiring gastrostomy is in keeping with other studies.…”

“…Several studies report increased complication rates in NI children (2,10,15). Other paediatric studies have observed a higher rate of complications when gastrostomy insertion is combined with fundoplication surgery (8,9,16). In our study, gastrostomy site‐related complications were common.…”

“…Concurrent fundoplication or NI status did not significantly increase the risk of hypergranulation. Minor complications may be underreported in the literature because they do not significantly affect quality of life (8). Gastrostomy site complications also included infection and excoriation; these also occurred frequently (63.6% and 33.6%, respectively).…”

“…Standard methods include open surgical, laparoscopic, percutaneous endoscopic gastrostomy (PEG), and radiologically placed. The first 3 may be combined with antireflux surgery (6)(7)(8).…”

Advances in Gastrostomy Placement and Care in Children

“…In our series of 20 patients undergoing laparoscopic fundoplication and placement of FREKA® PEG we demonstrated no obvious adverse impact of this procedure when compared to laparoscopic fundoplication alone. The placement, or indeed replacement, of a PEG at the conclusion of an anti-reflux procedure is occasionally mandated, particularly in neuro-developmentally delayed children, as it is safe and does not appear to impact on the efficacy of the fundoplication (Barber et al 2009). …”