Pediatric Gastrostomy Tube Placement: Less Complications Associated with Laparoscopic Approach

Rebecca A. Saberi, Gareth P. Gilna, Blaire V. Slavin, Antoine J. Ribieras, Alessia C. Cioci, Eva M. Urrechaga, Joshua P. Parreco, Eduardo A. Perez, Juan E. Sola, Chad M. Thorson

Research output: Contribution to journalArticlepeer-review

Abstract

Background: There are few nationwide studies comparing outcomes of open, laparoscopic (LAP), and percutaneous endoscopic (PEG) gastrostomy tube (GT) placement in the pediatric population. Materials and Methods: The Nationwide Readmissions Database from 2010 to 2014 was used to identify patients ≤18 years (excluding newborns) who underwent GT placement. Demographics, hospital characteristics, and outcomes were compared by the GT approach. Results: There were 3278 patients (41% female, age 3 ± 5 years) identified who underwent GT placement (40% open versus 32% PEG versus 28% LAP). Following an open approach, there were higher rates of GT-related complications (10% versus 4% LAP versus 3% PEG) and postoperative gastrointestinal issues (24% versus 12% LAP versus 9% PEG) on index hospitalization, both P < .001. Readmission within 30 days and 1 year were 18% and 43%, respectively. Overall readmission rates were not affected by the GT approach (44% open versus 44% LAP versus 43% PEG, P = .773). However, readmission for GT-related complications was the lowest following the LAP approach (<0.3% versus 2% open versus 2% PEG, P < .001). When those who also underwent fundoplication were excluded, conversion to gastrojejunostomy or jejunostomy (GJ/J) on readmission was higher following open and PEG approaches (4% open versus 2% PEG versus 0% LAP, P = .039). Conclusions: Compared with PEG gastrostomy and open gastrostomy, LAP GT placement appears to have lower index complications and reoperation rates, and at least comparable readmission outcomes. Despite these advantages, LAP GT placement remains underutilized.

Original languageEnglish (US)
Pages (from-to)1376-1383
Number of pages8
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume31
Issue number12
DOIs
StatePublished - Dec 1 2021
Externally publishedYes

Keywords

  • Complications
  • Gastrostomy tube
  • Laparoscopy
  • PEG
  • Readmissions

ASJC Scopus subject areas

  • Surgery

Fingerprint

Dive into the research topics of 'Pediatric Gastrostomy Tube Placement: Less Complications Associated with Laparoscopic Approach'. Together they form a unique fingerprint.

Cite this