Outcomes After Laparoscopic Gastrostomy Suture Techniques in Children

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Surgical Techniques

Background:

• Laparoscopic gastrostomy involves securing the stomach to the abdominal wall using various suture techniques.
• The comparative safety of temporary fixation versus subcutaneous absorbable sutures in pediatric patients is not well-established.
• Understanding suture technique impact on postoperative complications is crucial for patient care.

Purpose of the Study:

• To evaluate if specific suture techniques for laparoscopic gastrostomy in children are associated with increased postoperative complications.
• To compare the rates of major and minor complications between temporary and subcutaneous absorbable suture groups.

Main Methods:

• Retrospective cohort analysis of pediatric patients (<18 years) undergoing laparoscopic gastrostomy (2012-2016).
• Patients categorized by suture technique: temporary sutures vs. subcutaneous absorbable sutures.
• Postoperative outcomes (30-day) assessed for major (tube dislodgement, reoperation, readmission) and minor complications (stitch abscess, SSI, ED visit).
• Chi-squared test used for statistical comparison.

Main Results:

• 682 pediatric patients analyzed; 301 (44%) received subcutaneous sutures, 381 (56%) received temporary sutures.
• Overall major and minor complication rates were 8.3% and 22%, respectively.
• A significantly higher rate of major postoperative complications was observed in the subcutaneous suture group (11%) compared to the temporary suture group (6.3%, P=0.029).
• No significant difference in minor complication rates between the two groups.

Conclusions:

• Pediatric patients undergoing laparoscopic gastrostomy with subcutaneous sutures face a higher risk of major postoperative complications.
• Temporary suture techniques may be associated with a lower risk of major complications in this population.
• Suture technique selection is an important consideration to minimize adverse outcomes in pediatric laparoscopic gastrostomy.