Same-day discharge for pediatric laparoscopic gastrostomy

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Outpatient Care

Background:

• Laparoscopic gastrostomy is a common pediatric surgical procedure.
• A same-day discharge (SDD) protocol was developed for laparoscopic button gastrostomy.

Purpose of the Study:

• To evaluate the safety and feasibility of a same-day discharge protocol for pediatric laparoscopic button gastrostomy.
• To assess admission rates and emergency room visits for children discharged on the same day.

Main Methods:

• Prospective observational study of children undergoing laparoscopic button gastrostomy eligible for SDD.
• Eligibility criteria included family comfort with outpatient surgery, absence of major co-morbidities, no additional procedures requiring admission, and pre-operative education.
• Data collected on patient demographics, operative time, feeding initiation, length of stay, admissions, and post-operative emergency room visits.

Main Results:

• 62 pediatric patients were eligible for the SDD protocol.
• 82% (51 patients) were discharged the same day, with a median length of stay of 9 hours.
• 11 patients (18%) were admitted, most commonly for further teaching. 11 patients visited the ER within 30 days, primarily for mechanical complications.

Conclusions:

• Same-day discharge following laparoscopic gastrostomy is a safe and feasible option for select pediatric patients.
• The SDD pathway is associated with a low rate of hospital admission and a relatively low incidence of post-operative emergency room visits.