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Laparoscopic versus percutaneous endoscopic gastrostomy placement in children: Results of a systematic review and

Nutnicha Suksamanapun1, Femke A Mauritz2, Josephine Franken1

  • 1Department of Pediatric Surgery, Wilhelmina Children's Hospital, Utrecht, The Netherlands.

Journal of Minimal Access Surgery
|June 3, 2016
PubMed

Insights

Percutaneous endoscopic gastrostomy (PEG) had more complications than laparoscopic-assisted gastrostomy (LAG) in children, including bowel injuries and dislodgements. More research is needed to confirm these findings for pediatric gastrostomy procedures.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Minimally Invasive Procedures

Background:

  • Percutaneous endoscopic gastrostomy (PEG) and laparoscopic-assisted gastrostomy (LAG) are common procedures in pediatric patients.
  • The comparative effectiveness and safety of PEG versus LAG in children require further investigation.

Purpose of the Study:

  • To systematically review and compare the efficacy and safety of PEG and LAG in the pediatric population.
  • To identify which gastrostomy procedure offers better outcomes regarding success rate, feeding efficacy, quality of life, gastroesophageal reflux, and complications.

Main Methods:

  • A systematic review and meta-analysis was conducted following PRISMA guidelines.
  • Included studies compared PEG and LAG in pediatric patients, analyzing outcomes such as success rate, feeding efficacy, quality of life, reflux, and complications.

Main Results:

  • Five retrospective studies involving 550 PEG and 483 LAG placements were analyzed.
  • PEG was associated with significantly higher rates of adjacent bowel injuries, early tube dislodgements, and complications requiring reintervention under general anesthesia compared to LAG.
  • The overall completion rate and frequency of minor complications were similar between PEG and LAG.

Conclusions:

  • Current evidence suggests PEG may be associated with a higher risk of specific complications in pediatric patients compared to LAG.
  • The lack of well-designed randomized controlled trials necessitates caution in drawing definitive conclusions.
  • Randomized controlled trials are crucial to establish best practices for gastrostomy placement in children.
Abstract

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