Is endoscopy beneficial in pediatric laparoscopic gastrostomy insertion; A 9-year comparative study

Area of Science:

• Pediatric surgery
• Gastroenterology
• Minimally invasive procedures

Background:

• Percutaneous endoscopic gastrostomy (PEG) placement has evolved with new techniques.
• Laparoscopic-assisted gastrostomy (LAG) and laparoscopic-assisted percutaneous endoscopic gastrostomy (LAPEG) are advanced options for pediatric gastrostomy.
• LAPEG combines endoscopy and laparoscopy for gastrostomy insertion.

Purpose of the Study:

• To compare the outcomes and complication rates of LAG and LAPEG techniques in pediatric patients.
• To evaluate the safety and efficacy of these minimally invasive gastrostomy procedures.

Main Methods:

• Retrospective review of pediatric LAG and LAPEG procedures from September 2010 to September 2019.
• Collection of patient demographics, procedural details, and 1-year complication data.
• Comparison of complication rates, operative time, and length of hospital stay between LAG and LAPEG groups.

Main Results:

• No significant differences in complication rates (conversion, peritoneal leak, re-operation, tube dislodgement, wound infection) between LAG and LAPEG.
• Minor serosal injury observed in one LAG patient; no bowel injury in LAPEG.
• LAPEG demonstrated a significantly shorter median operative time (11 minutes less) than LAG (p < 0.001).
• No significant difference in the median length of hospital stay between the two techniques (p < 0.096).

Conclusions:

• Both LAG and LAPEG are safe and effective methods for pediatric gastrostomy tube placement.
• Complication rates and hospital stay duration are comparable between LAG and LAPEG.
• The integration of endoscopy in LAPEG leads to reduced operative time compared to LAG.