Gastrostomy Feeding and Gastroesophageal Reflux

Sullivan, Peter B.

doi:10.1007/978-3-642-11202-7_99

Cited by 1 publication

(4 citation statements)

References 60 publications

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“…Yet, all five patients were medically using proton pump inhibitors, and none required further anti‐reflux surgery. This finding is comparable to other studies that similarly found low rates of further anti‐reflux surgery in PG patients 6,11,27,29 . Although none of the PAR group had reflux after the operation, a majority of PG patients (88.4%) also remained GOR‐free.…”

Section: Discussionsupporting

confidence: 88%

“…This finding is comparable to other studies that similarly found low rates of further anti-reflux surgery in PG patients. 6,11,27,29 Although none of the PAR group had reflux after the operation, a majority of PG patients (88.4%) also remained GORfree. On the other hand, the PAR group had a longer operative time and higher conversion rate.…”

Section: Discussionmentioning

confidence: 96%

“…5 Previous studies have reported that gastrostomy insertion is associated with gastroesophageal reflux (GOR). [8][9][10][11] These studies often report a change in laxity of the lower esophageal sphincter, [8][9][10] leading to a reflux of stomach contents. Additionally, patients with NI have also been previously reported to have a higher risk of developing GOR.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have reported that gastrostomy insertion is associated with gastroesophageal reflux (GOR) 8–11 . These studies often report a change in laxity of the lower esophageal sphincter, 8–10 leading to a reflux of stomach contents.…”

Section: Introductionmentioning

confidence: 99%

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Prophylactic anti‐reflux procedure for children undergoing laparoscopic gastrostomy: Rethinking of the routine practice

Fung,

Ooi,

Hui

et al. 2024

World j. surg.

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AimLaparoscopic gastrostomy is a frequently performed procedure in children requiring long‐term enteral nutrition. The role of prophylactic anti‐reflux surgery during gastrostomy placements is controversial. The current study aims to evaluate the role of prophylactic anti‐reflux procedures during gastrostomy placement.MethodsA retrospective single‐center analysis of all children without reflux receiving laparoscopic gastrostomy from January 2005 through December 2021 was performed. Demographics and clinical outcomes were compared between patients receiving gastrostomy placement alone and patients receiving gastrostomy with prophylactic anti‐reflux surgery.ResultsA total of 79 patients had a confirmed absence of reflux by a 24‐h pH/impedance study before operation. Thirty‐six of these patients underwent prophylactic anti‐reflux surgery (PAR) while 43 received gastrostomy (PG) alone. The operative time and conversion rate were significantly higher in the PAR group (140.5 ± 67.5 vs. 80.2 ± 66.8 min, p = 0.0001 and 8.3% vs. 0%, p = 0.04). There were no major complications in either group. De novo reflux was detected in five patients (11.6%) in the PG group. None of these patients progressed to require anti‐reflux surgery.ConclusionThe occurrence of de novo reflux after laparoscopic gastrostomy was low and could be managed without anti‐reflux surgery. A routine pre‐operative pH study is helpful for appropriate patient selection to avoid unnecessary anti‐reflux surgery, which lengthens operative time and increases the conversion rate.

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Section: Discussionsupporting

confidence: 88%