Endoscopic button gastrostomy: Comparing a sutured endoscopic approach to the current techniques

Area of Science:

• Pediatric surgery
• Gastroenterology
• Minimally invasive procedures

Background:

• Button gastrostomy is a preferred feeding device for children.
• Traditional placement methods include open, laparoscopic button gastrostomy (LBG), and percutaneous endoscopic gastrostomy (PEG) with subsequent exchange.
• Endoscopic-assisted button gastrostomy (EBG) offers a combined approach with a single incision.

Purpose of the Study:

• To compare the long-term outcomes and potential costs of EBG with LBG and PEG.
• To evaluate the safety and efficacy of EBG in pediatric patients.

Main Methods:

• A retrospective comparison of children undergoing EBG, LBG, and PEG between 2010-2013.
• Analysis of patient demographics, procedure duration, complication rates, and follow-up visits (clinic and ER) over eight weeks.

Main Results:

• Demographics were similar across groups (32 patients/group).
• EBG had a significantly shorter mean procedure time (38 min) compared to LBG (58 min; p<0.0001), but similar to PEG (31 min).
• Fewer infections were observed in the EBG group, with similar ER visits but fewer clinic visits compared to PEG. 97% of PEG patients required subsequent exchange to a button gastrostomy.

Conclusions:

• EBG is a safe and effective alternative for pediatric gastrostomy placement.
• EBG demonstrates a shorter procedure time than LBG and avoids the need for laparoscopy or device exchange.
• The EBG technique may offer potential cost reductions by eliminating the need for device exchange and fluoroscopic confirmation.