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Complication rate after gastrostomy placement in children can be reduced by simple surgical steps

Hössjer, Therese ; Göthberg, Gunnar ; Arnbjörnsson, Einar LU ; Rutqvist, Jan ; Perris, Frans ; Bartik, Zsuzsa ; Almström, Markus ; Backman, Torbjörn LU and Danielson, Johan (2023) In Acta Pædiatrica 112(7). p.1597-1604
Abstract

AIM: To evaluate if the incidence of postoperative complications after gastrostomy placement is correlated to perioperative parameters or patient characteristics.

METHODS: In this prospective observational study, children <18 years of age planned to receive a gastrostomy at partaking clinics between 2014 and 2019 were invited. Pre-, peri- and postoperative variables were collected and followed up 3 months postoperatively.

RESULTS: Five hundred and eighty-two patients were included (median age: 26 months, median weight: 10.8 kg), mainly laparoscopic (52.0%) and push-PEG (30.2%) technique used. The incidence of complications was lower in the group of patients receiving a gastrostomy tube that was 2 mm longer than the... (More)

AIM: To evaluate if the incidence of postoperative complications after gastrostomy placement is correlated to perioperative parameters or patient characteristics.

METHODS: In this prospective observational study, children <18 years of age planned to receive a gastrostomy at partaking clinics between 2014 and 2019 were invited. Pre-, peri- and postoperative variables were collected and followed up 3 months postoperatively.

RESULTS: Five hundred and eighty-two patients were included (median age: 26 months, median weight: 10.8 kg), mainly laparoscopic (52.0%) and push-PEG (30.2%) technique used. The incidence of complications was lower in the group of patients receiving a gastrostomy tube that was 2 mm longer than the gastrostomy canal (p < 0.001-0.025), and a thickness of 12 Fr (p < 0.001-0.009). These findings were confirmed by multivariate analysis also including operative technique, age and weight. Patients with oncological disease had significantly higher incidence of pain and infection but the lowest incidence of granulomas (p < 0.001-0.01).

CONCLUSION: This study indicates that a 12 Fr gastrostomy tube that is 2 mm longer than the gastrostomy canal is correlated with the lowest incidence of postoperative complications the first 3 months after surgery. Oncological patients had the lowest incidence of granulomas which probably is related to chemotherapy.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Child, Child, Preschool, Gastrostomy/adverse effects, Enteral Nutrition/methods, Retrospective Studies, Laparoscopy/adverse effects, Postoperative Complications/epidemiology, gastrostomy, paediatric surgery, postoperative complications, tube feeding
in
Acta Pædiatrica
volume
112
issue
7
pages
8 pages
publisher
Wiley-Blackwell
external identifiers
  • pmid:37073475
  • scopus:85158069171
ISSN
1651-2227
DOI
10.1111/apa.16792
language
English
LU publication?
yes
additional info
© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.
id
84f4d4d1-6146-4292-8905-b77b5fdffe24
date added to LUP
2023-07-05 14:06:28
date last changed
2024-11-30 22:49:38
@article{84f4d4d1-6146-4292-8905-b77b5fdffe24,
  abstract     = {{<p>AIM: To evaluate if the incidence of postoperative complications after gastrostomy placement is correlated to perioperative parameters or patient characteristics.</p><p>METHODS: In this prospective observational study, children &lt;18 years of age planned to receive a gastrostomy at partaking clinics between 2014 and 2019 were invited. Pre-, peri- and postoperative variables were collected and followed up 3 months postoperatively.</p><p>RESULTS: Five hundred and eighty-two patients were included (median age: 26 months, median weight: 10.8 kg), mainly laparoscopic (52.0%) and push-PEG (30.2%) technique used. The incidence of complications was lower in the group of patients receiving a gastrostomy tube that was 2 mm longer than the gastrostomy canal (p &lt; 0.001-0.025), and a thickness of 12 Fr (p &lt; 0.001-0.009). These findings were confirmed by multivariate analysis also including operative technique, age and weight. Patients with oncological disease had significantly higher incidence of pain and infection but the lowest incidence of granulomas (p &lt; 0.001-0.01).</p><p>CONCLUSION: This study indicates that a 12 Fr gastrostomy tube that is 2 mm longer than the gastrostomy canal is correlated with the lowest incidence of postoperative complications the first 3 months after surgery. Oncological patients had the lowest incidence of granulomas which probably is related to chemotherapy.</p>}},
  author       = {{Hössjer, Therese and Göthberg, Gunnar and Arnbjörnsson, Einar and Rutqvist, Jan and Perris, Frans and Bartik, Zsuzsa and Almström, Markus and Backman, Torbjörn and Danielson, Johan}},
  issn         = {{1651-2227}},
  keywords     = {{Humans; Child; Child, Preschool; Gastrostomy/adverse effects; Enteral Nutrition/methods; Retrospective Studies; Laparoscopy/adverse effects; Postoperative Complications/epidemiology; gastrostomy; paediatric surgery; postoperative complications; tube feeding}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{1597--1604}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Pædiatrica}},
  title        = {{Complication rate after gastrostomy placement in children can be reduced by simple surgical steps}},
  url          = {{http://dx.doi.org/10.1111/apa.16792}},
  doi          = {{10.1111/apa.16792}},
  volume       = {{112}},
  year         = {{2023}},
}