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Comparison of major complications in children after laparoscopy-assisted gastrostomy and percutaneous endoscopic gastrostomy placement : a meta-analysis

Sandberg, Filip; Viktorsdóttir, Margrét Brands; Salö, Martin LU ; Stenström, Pernilla LU and Arnbjörnsson, Einar LU (2018) In Pediatric Surgery International 34(12). p.1321-1327
Abstract

PURPOSE: A meta-analysis was performed to compare the rates of the major complications associated with two gastrostomy tube placement techniques in a pediatric population: laparoscopy-assisted gastrostomy (LAG) and percutaneous endoscopic gastrostomy (PEG).

METHODS: The PubMed electronic database was queried for comparative studies of the two insertion techniques. The Newcastle-Ottawa scale (NOS) was used for the assessment of the quality and risk of bias in the included studies. The main outcome measure was the frequency of major complications defined as the need for reoperation within 30 days or death. RevMan 5.3, was used, with a p < 0.05 indicating statistical significance.

RESULTS: Eight studies including 1550... (More)

PURPOSE: A meta-analysis was performed to compare the rates of the major complications associated with two gastrostomy tube placement techniques in a pediatric population: laparoscopy-assisted gastrostomy (LAG) and percutaneous endoscopic gastrostomy (PEG).

METHODS: The PubMed electronic database was queried for comparative studies of the two insertion techniques. The Newcastle-Ottawa scale (NOS) was used for the assessment of the quality and risk of bias in the included studies. The main outcome measure was the frequency of major complications defined as the need for reoperation within 30 days or death. RevMan 5.3, was used, with a p < 0.05 indicating statistical significance.

RESULTS: Eight studies including 1550 patients met the inclusion criteria. The risk for major complications was higher in PEG than in LAG 3.86 (95% confidence interval 1.90-7.81; p < 0.0002). The number needed to treat to reduce one major complication by performing LAG instead of PEG was 23. There were no randomized-controlled trials. Overall, the quality of the included studies was determined to be unsatisfactory.

CONCLUSIONS: PEG placement was associated with a significantly higher risk of major complications compared to LAG placement. Therefore, LAG should be the preferred method for gastrostomy tube placement in children.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Pediatric Surgery International
volume
34
issue
12
pages
1321 - 1327
publisher
Springer
external identifiers
  • scopus:85054598370
ISSN
1437-9813
DOI
10.1007/s00383-018-4358-6
language
English
LU publication?
yes
id
6709d4d7-7aa6-4001-b5c4-d33fc7d78706
date added to LUP
2018-10-11 18:16:42
date last changed
2019-02-20 11:31:12
@article{6709d4d7-7aa6-4001-b5c4-d33fc7d78706,
  abstract     = {<p>PURPOSE: A meta-analysis was performed to compare the rates of the major complications associated with two gastrostomy tube placement techniques in a pediatric population: laparoscopy-assisted gastrostomy (LAG) and percutaneous endoscopic gastrostomy (PEG).</p><p>METHODS: The PubMed electronic database was queried for comparative studies of the two insertion techniques. The Newcastle-Ottawa scale (NOS) was used for the assessment of the quality and risk of bias in the included studies. The main outcome measure was the frequency of major complications defined as the need for reoperation within 30 days or death. RevMan 5.3, was used, with a p &lt; 0.05 indicating statistical significance.</p><p>RESULTS: Eight studies including 1550 patients met the inclusion criteria. The risk for major complications was higher in PEG than in LAG 3.86 (95% confidence interval 1.90-7.81; p &lt; 0.0002). The number needed to treat to reduce one major complication by performing LAG instead of PEG was 23. There were no randomized-controlled trials. Overall, the quality of the included studies was determined to be unsatisfactory.</p><p>CONCLUSIONS: PEG placement was associated with a significantly higher risk of major complications compared to LAG placement. Therefore, LAG should be the preferred method for gastrostomy tube placement in children.</p>},
  author       = {Sandberg, Filip and Viktorsdóttir, Margrét Brands and Salö, Martin and Stenström, Pernilla and Arnbjörnsson, Einar},
  issn         = {1437-9813},
  language     = {eng},
  number       = {12},
  pages        = {1321--1327},
  publisher    = {Springer},
  series       = {Pediatric Surgery International},
  title        = {Comparison of major complications in children after laparoscopy-assisted gastrostomy and percutaneous endoscopic gastrostomy placement : a meta-analysis},
  url          = {http://dx.doi.org/10.1007/s00383-018-4358-6},
  volume       = {34},
  year         = {2018},
}