Complications according to underlying disease in children undergoing video-assisted gastrostomy
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Purpose: The aim of this study was to identify short-term complications after video-assisted gastrostomy in children and to examine the association between complications and underlying disease.
Methods: This was a retrospective study at a single institution. Data for all children who underwent video-assisted gastrostomy during 12 years was collected. Complications occurring within three months postoperatively were analyzed.
Results: Among 421 children undergoing video-assisted gastrostomy, 402 were included in the study. The median age at surgery was two years (range one month-14 years). The most common underlying disorder was neurological disease (49%). There were two major postoperative complications and 78% had minor complications. Minor complications included granulation tissue (43%), leakage (16%), wound infection (14%), vomiting, dislodgement and pain. There was no significant difference in frequency of the various complications when compared between the underlying diseases (p=0.10-0.82). Wound infection was registered in overall 14% and occurred least frequently in children with neurologic disease and syndromes (10% and 9% respectively).
Conclusion: Serious complications after video-assisted gastrostomy are rare, while minor complications occur in 78% of the children. There is no association between the frequency of complications and underlying disease according to this study.
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2. Lantz M, Hultin Larsson H, Arnbjörnsson E. Literature review comparing laparoscopic and percutaneous endoscopic gastrostomies in a pediatric population. Int J Pediatr. 2010:507616. doi: 10.1155/2010/507616. Epub 2010 Mar 10. PubMed PMID: 20300186 https://doi.org/10.1155/2010/507616
3. Shimizu Y, Okuyama H, Sasaki T, Nose S, Saka R. Laparoscopic-assisted percutaneous endoscopic gastrostomy: a simple and efficient technique for disabled elderly patients. J Parenter Enteral Nutr. 2014;38:475–480.
4. Yu SC, Petty JK, Bensard DD, Partrick DA, Bruny JL, Hendrickson RJ. Laparoscopic-assisted percutaneous endoscopic gastrostomy in children and adolescents. JSLS. 2005 Jul-Sep;9(3):302-4.
PMCID: PMC3015611 PMID: 16121876 [Indexed for MEDLINE]
5. Idowu O, Driggs XA, Kim S. Laparoscopically assisted antegrade percutaneous endoscopic gastrostomy. J Pediatr Surg. 2010;45:277–279.
6. Given MF, Hanson JJ, Lee MJ. Interventional radiology techniques for provision of enteral feeding. Cardiovasc Intervent Radiol. 2005;28:692–703.
7. Akay B, Capizzani TR, Lee AM, Drongowski RA, Geiger JD, Hirschl RB, Mychaliska GB. Gastrostomy tube placement in infants and children: is there a preferred technique? J Pediatr Surg. 2010;45:1147–1152. https://doi.org/10.1016/j.jpedsurg.2010.02.079 PMid:20620310
8. Jones VS, La Hei ER, Shun A. Laparoscopic gastrostomy: the preferred method of gastrostomy in children. Pediatr Surg Int. 2007;23:1085–1089.
9. Vervloessem D, van Leersum F, Boer D, Hop WC, Escher JC, Madern GC, de Ridder L, Bax KN. Percutaneous endoscopic gastrostomy (PEG) in children is not a minor procedure: risk factors for major complications. Semin Pediatr Surg. 2009;18:93–97.
10. Zamakhshary M, Jamal M, Blair GK, Murphy JJ, Webber EM, Skarsgard ED. Laparoscopic vs percutaneous endoscopic gastrostomy tube insertion: a new pediatric gold standard? J Pediatr Surg. 2005;40:859–862.
11. Liu R, Jiwane A, Varjavandi A, Kennedy A, Henry G, Dilley A, Currie B, Adams S, Krishnan U. Comparison of percutaneous endoscopic, laparoscopic and open gastrostomy insertion in children. Pediatr Surg Int. 2013;29:613–621.
12. Backman T, Sjövie H, Kullendorff CM, Arnbjörnsson E. Continuous double U-stitch gastrostomy in children. Eur J Pediatr Surg. 2010; 20:14-17
13. Mikaelsson C, Arnbjörnsson E. Single-puncture laparoscopic gastrostomy in children. Pediatr Surg Int. 1998;14:43–44.
14. Arnbjörnsson E, Larsson LT, Lindhagen T. Complications of laparoscopy-aided gastrostomies in pediatric practice. J Pediatr Surg. 1999; 34:1843-1846
15. Andersson L, Mikaelsson C, Arnbjörnsson E, Larsson LT. Laparoscopy aided gastrostomy in children. Ann Chir Gynaecol. 1997; 86:19-22.
16. Norén E, Gunnarsdóttir A, Hanséus K, Arnbjörnsson E. Laparoscopic gastrostomy in children with congenital heart disease. J Laparoendosc Adv Surg Tech A. 2007; 17:483-489.
17. Backman T, Berglund Y, Sjövie H, Arnbjörnsson E. Complications of video-assisted gastrostomy in children with or without a ventriculoperitoneal shunt. Pediatr Surg Int. 2007; 23:665-668 https://doi.org/10.1007/s00383-007-1930-x
18. Plantin I, Arnbjörnsson E, Larsson LT. No increase in gastroesophageal reflux after laparoscopic gastrostomy in children. Pediatr Surg Int. 2006; 22:581-584
19. Arnbjörnsson E, Backman T, Mörse H, Berglund Y, Kullendorff CM, Lövkvist H. Complications of video-assisted gastrostomy in children with malignancies or neurological diseases. Acta Paediatr. 2006; 95:467-470
20. Backman T, Arnbjörnsson E, Berglund Y, Larsson LT. Video-assisted gastrostomy in infants less than 1 year. Pediatr Surg Int. 2006; 22:243-246.
21. Schrag SP, Sharma R, Jaik NP, Seamon MJ, Lukaszczyk JJ, Martin ND, Hoey BA, Stawicki SP. Complications related to percutaneous endoscopic gastrostomy (PEG) tubes. A comprehensive clinical review. J Gastrointest Liver Dis. 2007;16:407–418.
22. Khalil Q, Kibria R, Akram S. Acute buried bumper syndrome. South Med J. 2010;103:1256–1258. https://doi.org/10.1097/SMJ.0b013e3181fa73d0
23. Salö M, Santimano A, Helmroth S, Stenström P, Arnbjornsson EÓ. Long-term outcomes of children undergoing video-assisted gastrostomy. Pediatr Surg Int. 2016 Nov 2. [Epub ahead of print] PubMed PMID: 27807610.
24. Wragg RC, Salminen H, Pachl M, Singh M, Lander A, Jester I, Parikh D, Jawaheer G. Gastrostomy insertion in the 21st century: PEG or laparoscopic? Report from a large single-centre series. Pediatr Surg Int. 2012;28:443–448.
25. Cyrany J, Rejchrt S, Kopacova M, Bures J. Buried bumper syndrome: A complication of percutaneous endoscopic gastrostomy. World J Gastroenterol. 2016; 22:618-627 .
https://doi.org/10.3748/wjg.v22.i2.618 PMid:26811611 PMCid:PMC4716063