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Laparoscopic secondary antireflux procedure after PEG placement in children. Percutaneous endoscopic gastrostomy
D C van der Zee1, N M Bax, B M Ure
1Department of Pediatric Surgery, KE 04.140.5, Wilhelmina Children's Hospital, University Medical Center, P.O. Box 85090, 3508 AB Utrecht, The Netherlands.
Insights
This study shows that prior percutaneous endoscopic gastrostomy (PEG) placement does not negatively impact subsequent laparoscopic antireflux surgery. Laparoscopic antireflux procedures can be safely performed after PEG placement.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
Background:
- Investigating the feasibility of laparoscopic antireflux surgery following percutaneous endoscopic gastrostomy (PEG) placement.
- Assessing potential complications or challenges in patients with prior PEG.
Purpose of the Study:
- To determine if a prior PEG affects the success or safety of a subsequent laparoscopic antireflux procedure.
- To evaluate the outcomes of laparoscopic antireflux surgery in patients with a history of PEG.
Main Methods:
- A retrospective review of five patients who underwent laparoscopic antireflux procedures between 1997 and 1998.
- All patients had a pre-existing gastrostomy tube and presented with persistent vomiting.
Main Results:
- Laparoscopic antireflux procedures were successfully performed in all five patients.
- A four-trocar technique was utilized in all cases, demonstrating feasibility.
Conclusions:
- Initial percutaneous endoscopic gastrostomy (PEG) placement does not adversely affect outcomes of secondary laparoscopic antireflux surgery.
- The use of a four-trocar technique is feasible and effective in these cases.
Background:
This study investigates the feasibility of performing a subsequent laparoscopic antireflux procedure after former placement of a percutaneous endoscopic gastrostomy (PEG).
Methods:
Between 1997 and 1998, five patients with a gastrostomy in place presented with an indication for laparoscopic antireflux procedure due to persisting vomiting.
Results:
All patients were managed laparoscopically with a four-trocar technique.
Conclusions:
Primary PEG placement has no adverse effects on a later secondary antireflux procedure. In some cases, four rather than five trocars can be used.