Open Primary Button Versus Laparoscopic Percutaneous Endoscopic Gastrostomy: Results From a Case-control Study.

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Medical Devices

Background:

• Open primary balloon gastrostomy (PBG) is an alternative to percutaneous endoscopic gastrostomy (PEG) in children, potentially avoiding general anesthesia.
• The complication profile of PBG versus PEG in pediatric patients requires further definition.

Purpose of the Study:

• To compare the complication rates and outcomes of PBG and PEG in pediatric patients using a matched case-control study.

Main Methods:

• A matched case-control study compared 35 PBG cases with 105 PEG controls, matched by age and diagnosis.
• Complications were classified using the Clavien-Dindo system (I-V); secondary outcomes included time to feed and length of stay.
• Statistical analyses included non-parametric, categorical, and multivariate logistic regression.

Main Results:

• The overall complication rate was not statistically different between PBG and PEG.
• PBG had a significantly higher incidence of symptomatic granulation tissue (29% vs 6%, P = 0.0008).
• Operative time was longer for PBG (median 43 min vs 27.5 min, P < 0.001).

Conclusions:

• PBG and PEG demonstrate comparable overall complication rates in pediatric patients.
• PBG is associated with a higher risk of granulation tissue formation.
• The benefit of avoiding general anesthesia with PBG should be considered against the increased risk of granulation tissue.