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Outcome of laparoscopic versus open gastrostomy in children

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Abstract

Purpose

Laparoscopic gastrostomy (LAPG) has gained popularity in children. The aim of this study was to compare the outcome of LAPG versus open gastrostomy (OG) in children with focus on complications, operative times and postoperative length of stay.

Methods

Retrospective study of children who had gastrostomies inserted at our tertiary Pediatric Surgery Center from 2000 until 2013. The indications for a gastrostomy were an anticipated need for enteral support for at least 6 months. Totally 243 children were included in the study, 83 with LAPG and 160 with OG.

Results

We found a significant difference in postoperative length of stay, 3 days in the LAPG group versus 4 days in the OG group but no difference in a sub-group analysis from 2010 to 2013 when both techniques were used. There was no difference in median operative time or complications rates. Granuloma was the dominating complication in both groups.

Conclusion

These two feeding-access techniques are comparable regarding complications, operative times and postoperative length of stay. The choice of surgical method should be individualized based on the patient’s characteristics and the experience of the surgeon. The favorable results with LAPG in adults are not necessarily transferable to children since there are physiological and anatomical differences.

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Acknowledgments

The authors thank all the participating children and their parents and we thank Marcus Thuresson, Statisticon AB for statistical analyses. The authors also wish to thank the HRH Crown Princess Lovisa’s Foundation for Scientific Research for funding.

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Authors and Affiliations

  1. Department of Women’s and Children’s Health, Uppsala University, SE-751 85, Uppsala, Sweden

    Gertrud Angsten, Johan Danielson, Ann-Marie Kassa & Helene Engstrand Lilja

  2. Department of Pediatric Surgery, University Children’s Hospital, SE-751 85, Uppsala, Sweden

    Helene Engstrand Lilja

Authors
  1. Gertrud Angsten
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  2. Johan Danielson
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  3. Ann-Marie Kassa
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  4. Helene Engstrand Lilja
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Correspondence to Helene Engstrand Lilja.

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Angsten, G., Danielson, J., Kassa, AM. et al. Outcome of laparoscopic versus open gastrostomy in children. Pediatr Surg Int 31, 1067–1072 (2015). https://doi.org/10.1007/s00383-015-3791-z

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  • DOI: https://doi.org/10.1007/s00383-015-3791-z

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