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Gastrostomy Placement in Children: Percutaneous Endoscopic Gastrostomy or Laparoscopic Gastrostomy?

Laura Merli1, Erika A De Marco, Camilla Fedele

  • 1Division of Pediatric Surgery, Catholic University of the Sacred Heart, Policlinico "A. Gemelli", Rome, Italy.

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|September 24, 2016
PubMed

Insights

Laparoscopic gastrostomy (LG) shows fewer major complications than percutaneous endoscopic gastrostomy (PEG) in pediatric patients. LG is recommended, especially for newborns and those with specific medical conditions.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Minimally Invasive Procedures

Background:

  • Gastrostomy placement is crucial for nutritional support in pediatric patients.
  • Percutaneous endoscopic gastrostomy (PEG) and laparoscopic gastrostomy (LG) are the primary methods.
  • Comparative outcome data for these procedures in children is essential.

Purpose of the Study:

  • To compare the outcomes and complication rates of PEG versus LG in pediatric patients.
  • To identify the preferred gastrostomy technique based on safety and efficacy.
  • To evaluate the suitability of each procedure for specific pediatric subpopulations.

Main Methods:

  • Retrospective study of 69 pediatric patients undergoing gastrostomy.
  • Group 1: 37 patients (54%) underwent PEG.
  • Group 2: 32 patients (46%) underwent LG.

Main Results:

  • Five major complications occurred exclusively in the PEG group (13.5%), versus none in the LG group (P<0.05).
  • Minor complications were observed in 4 PEG patients (10.8%) and 8 LG patients (25%), with no statistical significance.
  • Laparoscopic gastrostomy demonstrated a superior safety profile regarding major complications.

Conclusions:

  • Laparoscopic gastrostomy is suggested as the preferred technique for pediatric gastrostomy placement.
  • LG is particularly recommended for newborns, children with skeletal malformations, and those with prior abdominal surgery.
  • Further research may explore long-term outcomes and cost-effectiveness of both procedures.

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