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Same-day discharge for pediatric laparoscopic gastrostomy.

Charlene Dekonenko1, Wendy Jo Svetanoff1, Obiyo O Osuchukwu1

  • 1Children's Mercy Hospital, Kansas City, MO.

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|October 28, 2020
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Summary

Same-day discharge (SDD) for pediatric laparoscopic gastrostomy is safe and feasible. This protocol allows select children to go home the same day, reducing hospital admissions and emergency room visits.

Keywords:
Button gastrostomyLaparoscopic gastrostomySame-day surgery

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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.