Gastrostomy insertion in the 21st century: PEG or laparoscopic? Report from a large single-centre series
| Autor: | Max J. Pachl, Ingo Jester, Anthony Lander, Ruth Wragg, Girish Jawaheer, Dakshesh Parikh, Heidi J. Salminen, Michael Singh |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.medical_treatment Treatment outcome Statistics Nonparametric Enteral Nutrition Postoperative Complications Percutaneous endoscopic gastrostomy Gastroscopy PEG ratio medicine Humans Prospective Studies Child Retrospective Studies Gastrostomy business.industry General surgery Suture Techniques technology industry and agriculture Infant General Medicine Length of Stay Surgery Single centre Treatment Outcome Child Preschool Pediatrics Perinatology and Child Health Female Laparoscopy business |
| Zdroj: | Pediatric Surgery International. 28:443-448 |
| ISSN: | 1437-9813 0179-0358 |
| DOI: | 10.1007/s00383-012-3079-5 |
| Popis: | To determine whether laparoscopic-assisted gastrostomy (LAG) has superseded percutaneous endoscopic gastrostomy (PEG) based on the clinical outcomes.A retrospective study was undertaken for the period January 06-December 09. Demographic and clinical outcomes were recorded and the two groups were compared.164 patients were studied (PEG, n = 107; LAG, n = 57). 93.5 % of PEG patients required two general anaesthetics compared with 8 % of LAG patients. Median time to using the gastrostomy was 24 (range 0-168) h in PEG and 0 (0-96) h in LAG patients (p0.001). Major complications occurred in 15/107 (14 %) of PEG and 2/57 (3.5 %) of LAG patients (p = 0.05). Re-operation rate following complications was 18/107 (16.8 %) for PEG and 3/57 (5.2 %) for LAG (p = 0.05). Minor complications arose in 41/107 (38 %) of PEG and 32/57 (56 %) of LAG (p = 0.05). Post-operative hospital stay was 2 (1-40) days for PEG and 2 (0-20) days for LAG (p = 0.01). The day-case rate was 0/107 for PEG and 5/57 (9 %) for LAG. There was no gastrostomy-related mortality in the series.LAG requires fewer anaesthetics, is associated with shorter time to feeding, shortened hospital stay and has a reduced risk of major complications. LAG is a very good alternative to the PEG in children. |
| Databáze: | OpenAIRE |
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