Gastrostomy complications in infants and children: a comparative study

Peters, Robert Thomas; Balduyck, Bram; Nour, S

doi:10.1007/s00383-010-2612-7

Cited by 35 publications

(17 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Another support of LAG prior PEG regarding complications has also been shown in a previous review of complications after gastrostomy placements [23] and a recent meta-analysis with fewer studies [24]. …”

Section: Discussionmentioning

confidence: 69%

See 1 more Smart Citation

Comparison of major complications in children after laparoscopy-assisted gastrostomy and percutaneous endoscopic gastrostomy placement: a meta-analysis

et al. 2018

View full text Add to dashboard Cite

PurposeA meta-analysis was performed to compare the rates of the major complications associated with two gastrostomy tube placement techniques in a pediatric population: laparoscopy-assisted gastrostomy (LAG) and percutaneous endoscopic gastrostomy (PEG).MethodsThe PubMed electronic database was queried for comparative studies of the two insertion techniques. The Newcastle–Ottawa scale (NOS) was used for the assessment of the quality and risk of bias in the included studies. The main outcome measure was the frequency of major complications defined as the need for reoperation within 30 days or death. RevMan 5.3, was used, with a p < 0.05 indicating statistical significance.ResultsEight studies including 1550 patients met the inclusion criteria. The risk for major complications was higher in PEG than in LAG 3.86 (95% confidence interval 1.90–7.81; p < 0.0002). The number needed to treat to reduce one major complication by performing LAG instead of PEG was 23. There were no randomized-controlled trials. Overall, the quality of the included studies was determined to be unsatisfactory.ConclusionsPEG placement was associated with a significantly higher risk of major complications compared to LAG placement. Therefore, LAG should be the preferred method for gastrostomy tube placement in children.

show abstract

Section: Discussionmentioning

confidence: 69%

“…For example, the creation of pneumoperitoneum during laparoscopic surgery may be unsafe in some patients with underlying respiratory disease. In addition, a history of prior upper abdominal surgery may complicate the operative course [23]. …”

Section: Discussionmentioning

confidence: 99%

Comparison of major complications in children after laparoscopy-assisted gastrostomy and percutaneous endoscopic gastrostomy placement: a meta-analysis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…The mean age at G-tube insertion in this group with PRS was 66 days (range 7-167 days, median 60 days) and mean weight 4.27 kg (range 1-7 kg, median 4.3 kg) compared to a mean age 3.9 years (range 1 day-23 years, median 1.53 years) and weight 13.4 kg (range 1-77 kg, median 8.6 kg) of our total population referred for a G-tube at this institution (unpublished data). This patient population is also younger and smaller than the mean age and weight of other pediatric reports in the literature [22][23][24][25][26]. Despite these demographics, the high technical success rate of radiologically placed G-tube insertions in this study (100%) is similar to that found in a meta-analysis by Wollman et al [27] of 99.2% for radiologically placed G-tubes, and compares well to the rate of 95% for PEG and 98.5% placed by laparoscopy [23].…”

Section: Discussionmentioning

confidence: 89%

Percutaneous gastrostomy tubes in children with Pierre Robin sequence: efficacy, maintenance and complications

et al. 2011

View full text Add to dashboard Cite

show abstract

“…1,2 This approach provides visualization of the stomach but not the peritoneal cavity, which can lead to injuries to the colon, small bowel, liver and spleen. [6][7][8][9][10][11] Another disadvantage is that the long PEG tube must be left in place for a few months before it can be exchanged for a skin-level device. This requires additional sedation, general anesthetic, or endoscopic retrieval.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic-assisted percutaneous endoscopic gastrostomy: insertion of a skin-level device using a tear-away sheath

Livingston

Pepe

Jones

et al. 2015

cjs

View full text Add to dashboard Cite

Background: This study describes our experience with the placement of a skin-level gastrostomy device (MIC-KEY) in a single procedure. Methods:We identified infants, children and young adults who underwent laparoscopicassisted percutaneous endoscopic gastrostomy (LAPEG) tube insertion between October 2009 and June 2013. The steps of this procedure include upper endoscopy, single-port laparoscopy, gastropexy via percutaneous T-fasteners and placement of a skin-level gastrostomy device (MIC-KEY) using a "push" technique with a tearaway sheath. Results:We included 92 patients in our study. Mean age was 3.7 years (range 3 wk-5 yr), and mean weight was 11.2 (range 2.8-54) kg. Median procedural time was 20 (range 12-76) minutes. Total median duration for the most recent 25 procedures was lower than that of the first 25 (62 v. 79 min, p = 0.004). There were no intraoperative complications or conversions to open surgery. Postoperative complications were observed in 6 (6.5%) patients. Three retained T-fasteners were assessed endoscopically (n = 1) or removed via local excision (n = 2). Two patients experienced early dislodged feeding tubes that were replaced via interventional radiology (n = 1) or repeat LAPEG (n = 1). There was also 1 intra-abdominal fluid collection that was drained percutaneously but ultimately required a laparotomy and washout. There were no major complications in the most recent 50 procedures. Conclusion:Our results suggest that LAPEG is a safe, minimally invasive procedure for infants, children and young adults. This approach allows for immediate use of a skin-level gastrostomy device without the need for postoperative tube exchanges.Contexte : Cette étude décrit notre expérience avec la pose d'un dispositif de gastrostomie au niveau de la peau (MIC-KEY) en une seule intervention.

show abstract

Gastrostomy complications in infants and children: a comparative study

Abstract: The inadvertent formation of a gastrocolic fistula was avoided with the use of laparoscopy to aid PEG insertion.

Cited by 35 publications

References 5 publications

Comparison of major complications in children after laparoscopy-assisted gastrostomy and percutaneous endoscopic gastrostomy placement: a meta-analysis

Comparison of major complications in children after laparoscopy-assisted gastrostomy and percutaneous endoscopic gastrostomy placement: a meta-analysis

Percutaneous gastrostomy tubes in children with Pierre Robin sequence: efficacy, maintenance and complications

Laparoscopic-assisted percutaneous endoscopic gastrostomy: insertion of a skin-level device using a tear-away sheath

Contact Info

Product

Resources

About