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Assessing clinical outcomes of modified laparoscopic gastrostomy in children: a case control study
Hussein Naji1,2, Aafia Gheewale3, Ebtesam Safi2
1Mediclinic Parkview Hospital, Dubai, UAE.
Insights
Modified U-stitches laparoscopic gastrostomy (MLG) shows fewer complications, particularly leaks, compared to standard laparoscopic gastrostomy (LG) in children. This technique offers a potentially safer approach for pediatric gastrostomy placement.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Procedures
- Gastrointestinal Surgery
Background:
- Gastrostomy is a common pediatric surgical procedure.
- Surgeons continually modify techniques to reduce challenges and complications.
- Modified U-stitches laparoscopic gastrostomy (MLG) is an emerging technique.
Purpose of the Study:
- To evaluate and compare the outcomes of MLG versus standard laparoscopic gastrostomy (LG).
- To assess complication rates associated with each gastrostomy technique in children.
Main Methods:
- Retrospective review of 89 pediatric gastrostomy procedures (2013-2020).
- Comparison of MLG and LG outcomes, focusing on postoperative complications.
- Key outcomes measured: gastrostomy button dislodgement, leakage, infection, and granulation tissue.
Main Results:
- Leakage around the button was significantly lower with MLG (4%) compared to LG (15%) (p=0.03).
- Overall complication rate for MLG was 63%, versus 73% for LG.
Conclusions:
- MLG demonstrates a reduced rate of complications compared to standard LG.
- MLG is a preferred technique for gastrostomy placement in pediatric patients.
Background:
With gastrostomy becoming a common surgical procedure within the pediatric population surgeons continued to introduce modifications on the procedure to overcome some of the challenges and minimize complications. Modified U-stitches laparoscopic gastrostomy is gaining favor in some centers including the center of this study. Hence, this study was conducted to evaluate and compare its outcomes.
Methods:
Eighty-nine gastrostomy procedures performed between 2013 and 2020 were reviewed to evaluate the surgical outcomes of a novel modified U-stitches laparoscopic gastrostomy (MLG) to the standard laparoscopic gastrostomy (LG) in children. The main outcome measured is the rate of postoperative complications encompassing dislodgement of gastrostomy button, leak around button, local infection, and development of granulation tissue post-surgery which is compared between the two population groups.
Results:
The rate of leak around the button was found to be significantly less in the MLG (4%) compared to (15%) in the traditional LG approach with a p-value of 0.03. However, the overall complication rate for MGL is 63%; while it is 73% for LG.
Conclusions:
The modified U-stitches laparoscopic gastrostomy has a lower rate of complications in comparison to the standard laparoscopic gastrostomy making it a preferred technique for gastrostomy placement in children.
