Outcome of laparoscopic versus open gastrostomy in children

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Gastroenterology

Background:

• Laparoscopic gastrostomy (LAPG) is increasingly used in pediatric surgery.
• Open gastrostomy (OG) is a traditional method for enteral feeding access.
• Comparing outcomes of LAPG and OG in children is crucial for surgical decision-making.

Purpose of the Study:

• To compare the outcomes of laparoscopic gastrostomy (LAPG) versus open gastrostomy (OG) in pediatric patients.
• To analyze complication rates, operative times, and postoperative length of stay for both procedures.
• To evaluate the efficacy and safety of LAPG compared to OG in children.

Main Methods:

• Retrospective study of 243 children who underwent gastrostomy insertion between 2000 and 2013.
• Inclusion criteria: anticipated need for enteral support for at least 6 months.
• Comparison between 83 children who had LAPG and 160 children who had OG.

Main Results:

• A significant difference in postoperative length of stay was observed: 3 days for LAPG versus 4 days for OG.
• No significant differences were found in median operative time or overall complication rates between LAPG and OG.
• Granuloma was the most frequent complication in both surgical groups.

Conclusions:

• Laparoscopic gastrostomy and open gastrostomy are comparable pediatric feeding access techniques regarding complications and operative times.
• Individualized patient characteristics and surgeon experience should guide the choice between LAPG and OG.
• Findings in adults do not directly translate to children due to physiological and anatomical differences.