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Updated: May 21, 2025

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
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Pediatric Gastrostomy Tube Placement: Avoid the Incision to Avoid the Complications.

Audra J Reiter1,2, Faraz Longi1, Benjamin L Thomae1

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PubMed
Summary

Gastrostomy tube placement techniques involving an incision around the tube are linked to increased complications. Laparoscopic or percutaneous endoscopic gastrostomy may offer better outcomes for pediatric patients.

Keywords:
gastrostomy tubepediatric surgerypostoperative complicationssurgical approach

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Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Surgical Outcomes

Background:

  • Significant variation exists in gastrostomy tube placement techniques.
  • Understanding the impact of operative approach on complication rates is crucial for optimizing patient care.

Purpose of the Study:

  • To investigate the association between different gastrostomy tube placement operative approaches and 30-day complication rates in pediatric patients.
  • To identify operative techniques associated with higher complication risks.

Main Methods:

  • Retrospective cohort study of 521 pediatric patients undergoing gastrostomy tube placement from June 2019 to April 2022.
  • Gastrostomy approaches analyzed: laparoscopic, laparoscopic-assisted, modified open, and percutaneous endoscopic gastrostomy (PEG).
  • Multivariable logistic regression controlled for prematurity and weight to assess complication associations.

Main Results:

  • Laparoscopic-assisted gastrostomy was associated with higher odds of overall complications.
  • Laparoscopic-assisted and modified open techniques showed increased odds of wound breakdown and leakage.
  • No significant association found between operative approach and reoperation, readmission, wound infection, or tube dislodgement.

Conclusions:

  • Gastrostomy placement techniques involving an incision around the tube (laparoscopic-assisted, modified open) are linked to higher complication rates.
  • Surgeons should consider laparoscopic or percutaneous endoscopic gastrostomy (PEG) to potentially improve complication profiles.
  • Operative approach significantly influences specific complication types, highlighting the need for technique selection in pediatric gastrostomy placement.