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Laparoscopic gastrostomy in children with congenital heart disease
Erik Norén1, Anna Gunnarsdóttir, Katarina Hanséus
1Department of Pediatric Surgery, University Hospital, Lund, Sweden.
Insights
Laparoscopic gastrostomy in children with congenital heart disease (CHD) showed a high complication rate and poor weight gain. Children with univentricular circulation experienced more severe complications, and overall weight gain was insufficient, indicating high energy needs in this population.
Area of Science:
- Pediatric Surgery
- Cardiology
- Gastroenterology
Background:
- Congenital heart disease (CHD) often requires nutritional support.
- Laparoscopic gastrostomy is a common intervention for feeding difficulties in pediatric patients.
- Understanding complication rates and nutritional outcomes in CHD patients undergoing gastrostomy is crucial.
Purpose of the Study:
- To evaluate complications and weight changes after laparoscopic gastrostomy in children with CHD.
- To compare outcomes between children with univentricular and biventricular circulation.
- To assess differences based on the completion status of cardiac surgery.
Main Methods:
- Retrospective study of 31 children with CHD undergoing laparoscopic gastrostomy (1995-2004).
- Analysis of postoperative complications and body weight changes during a mean 20-month follow-up.
- Comparison between patient subgroups based on cardiac circulation type and surgical completion.
Main Results:
- Minor stoma-related issues were frequent; severe complications occurred in 2 children with univentricular circulation.
- Children had normal birth weight but were underweight at gastrostomy and showed limited weight catch-up.
- No significant differences in mean weight gain were observed between the compared groups.
Conclusions:
- The laparoscopic gastrostomy complication rate in this CHD cohort exceeded that of other pediatric populations.
- Weight gain was consistently low, suggesting elevated energy expenditure in children with severe CHD.
- Further research into metabolic demands in these complex pediatric cases is warranted.
Aim:
The aim of this study was to study the type and frequency of complications and change in weight after a laparoscopic gastrostomy procedure in 31 children with congenital heart disease, comparing patient groups of children with univentricular and biventricular circulation, and with completed and uncompleted cardiac surgery.
Methods:
The method used was that of a retrospective study of all 31 children with congenital heart disease who underwent a laparoscopic gastrostomy at our center from 1995 to 2004.
Main Outcome Measures:
Postoperative complications and body weight changes during follow-up were the main outcome measures used in this study.
Results:
Minor stoma-related problems were common in both groups. Two severe complications requiring an operative intervention occurred in the univentricular circulation group. Weight was normal at birth, low at the time of the gastrostomy procedure, and did not catch up completely during the follow-up period of a mean of 20 months. There were no significant differences regarding mean weight gain between the groups.
Conclusions:
The complication rate after the laparoscopic gastrostomy procedure was higher in our patient group, compared to previously studied children with various diseases. Comparisons regarding mean weight gain between the groups showed no significant differences. The mean weight gain was low, suggesting that the energy expenditure in this patient group of children with severe congenital heart disease may be even higher than previously assumed.
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