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Severe gastro-oesophageal reflux necessitating fundoplication after percutaneous endoscopic and open gastrostomy in

Hannu Lintula1, Petri Juvonen, Inka Hämynen

  • 1Department of Paediatric Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland.

Langenbeck'S Archives of Surgery
|February 1, 2012
PubMed

Insights

Open gastrostomy (OG) and percutaneous endoscopic gastrostomy (PEG) have similar complication rates in children. However, OG was associated with a higher incidence of severe gastro-oesophageal reflux requiring fundoplication.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology

Background:

  • Gastrostomy is a common procedure in children requiring nutritional support.
  • Open gastrostomy (OG), percutaneous endoscopic gastrostomy (PEG), and laparoscopic-assisted gastrostomy are the primary techniques.

Purpose of the Study:

  • To compare the outcomes of open gastrostomy (OG) and percutaneous endoscopic gastrostomy (PEG) in pediatric patients.
  • To evaluate complication rates and clinical outcomes between OG and PEG procedures.

Main Methods:

  • Retrospective review of medical records for 69 pediatric patients undergoing gastrostomy between 1990 and 2008.
  • Comparison of outcomes between patients who received PEG (n=56) and OG (n=13).

Main Results:

  • No significant differences in patient characteristics, indications, or hospital stay between PEG and OG groups.
  • PEG procedures were significantly shorter (mean difference of 43 minutes).
  • Similar rates of subsequent surgical intervention (8% for both groups); however, severe gastro-oesophageal reflux requiring fundoplication was more frequent in the OG group (54% vs. 27% for PEG).

Conclusions:

  • Open gastrostomy in children is associated with a higher incidence of severe gastro-oesophageal reflux requiring fundoplication compared to PEG.
  • No significant differences were observed in overall complications or clinical outcomes between the two gastrostomy techniques.
Abstract

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