Laparoscopic assistance enables percutaneous endoscopic gastrostomy (PEG) in patients after prior abdominal and gastric surgery. Case series and review of the literature
| Autor: | Grzegorz Siergiejko, Wojciech Dębek, Ewa Matuszczak, Adam Hermanowicz, Katarzyna Kondej-Muszynska, Marta Komarowska |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Stomach medicine.medical_treatment General surgery digestive oral and skin physiology Peritonitis Perioperative medicine.disease Surgery Abdominal wall 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis Laparotomy Percutaneous endoscopic gastrostomy Pediatrics Perinatology and Child Health medicine 030211 gastroenterology & hepatology business Laparoscopy Abdominal surgery |
| Zdroj: | Pediatria Polska. 91:547-551 |
| ISSN: | 0031-3939 |
| DOI: | 10.1016/j.pepo.2016.09.002 |
| Popis: | Introduction Enteral feeding via gastrostomy tube is the treatment of choice for patients who are unable to tolerate oral feeding and are at risk for malnutrition. Because of its simplicity and effectiveness, percutaneous endoscopic gastrostomy (PEG) is nowadays considered the method of choice. To prevent complications, in children after prior abdominal and gastric surgeries, several methods have been reported to verify the anatomic relationship between the stomach and adjacent organs prior to gastric puncture. The aim of the study: we wanted to present our experience with the use of laparoscopic monitoring during the PEG procedure. Patients and methods Our case series include twelve patients who had had LAP-PEG procedure done after prior abdominal or gastric surgery. Nine patients were previously treated with ventriculoperitoneal shunts because of hydrocephalus. Two patients were previously operated on because of gastro-esophageal reflux. One patient was previously surgically treated because of Hirschsprung disease. Age at LAP-PEG ranged from 1 year 5 months to 17 years 1 month (mean 6 years 7 months) and weight ranged from 9 to 42 kg. The time between previous abdominal surgery and PEG insertion procedure ranged from 1 year 3 months to 17 years (mean 5 years 10 months). Results Mean duration of LAP-PEG was 41 min. In all patients, LAP-PEG was performed safely without perioperative complications. The mean length of hospital stay was 4 days (range from 3 to 6 days). Conclusions We believe that laparoscopic assistance diminishes the risk of major complications related to the PEG tube insertion procedure in children after previous laparotomy. Furthermore, adequate fixation of the stomach to the abdominal wall during LAP-PEG prevents the development of leakage and peritonitis. LAP-PEG should be considered the method of choice for obtaining enteral access in children after prior abdominal and especially gastric surgeries. |
| Databáze: | OpenAIRE |
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