Gastrostomy insertion in the 21st century: PEG or laparoscopic? Report from a large single-centre series

Abstract

LAG requires fewer anaesthetics, is associated with shorter time to feeding, shortened hospital stay and has a reduced risk of major complications. LAG is a very good alternative to the PEG in children.

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

“…22,23 In our experience, LAPEG using a tear-away sheath is a safe and minimally invasive procedure for gastrostomy tube insertion in patients of all ages, ranging from infants to young adults. The rate of major complications appears to be lower than published rates for PEG tube insertion in children (5%-19%) 2,9,10,21,22 and similar to those reported for the laparoscopic (2%-8%) 9,10,20,21,[23][24][25][26] and percutaneous radiologic techniques (4%-11%). 4,28 Furthermore, LAPEG with a tear-away sheath allows for the placement of a skin-level device in a single procedure.…”

“…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.…”

Complications according to underlying disease in children undergoing video-assisted gastrostomy

“…On the contrary, only a few major complications, including gastric perforation, gastrostomy dislodgment, and conversion to open procedure have been described in association with video-assisted gastrostomy. Minor complications, on the other hand, are equally encountered in both PEG and video-assisted gastrostomy 24 .…”

Experimental Study Of The Influence Laparoscopic Gastrostomy On The Emergence Of Gastroesophageal Reflux

“…На протяжении последних лет лапароскопиче-ский метод установки гастростомической трубки у детей стал доминирующей альтернативой откры-той операции [6]. Преимущества эндоскопического способа лечения включают сокращение длительно-сти хирургического вмешательства, быстрое восста-новление пациентов после операции, предотвраще-ние повреждения внутренних органов [7][8][9][10][11].…”