Surgical technique-related complications of pediatric gastrostomy

Introduction: Gastrostomy is a commonly performed procedure in pediatric patients, with various surgical techniques available for its application. However, no consensus exists regarding the optimal technique. This study aims to evaluate the outcomes and complications associated with different surgical techniques used for gastrostomy in children. Methods: This retrospective cohort study involved a review of medical records from patients who underwent gastrostomy using any of the four techniques employed at Fundación HOMI. A statistical analysis was conducted to determine the correlation between surgical technique and the occurrence of early and late complications. Results: A total of 350 patients were included in the study, with a mean age of 47.3 months (SD: 3 months). The open technique was utilized in 43.3 % of cases, endoscopic in 31.7 %, Laparoscopic-assisted percutaneous endoscopic gastrostomy in 12.6 %, and laparoscopic in 12.3 %. Early complications were observed in 27.1 % of patients, while late complications occurred in 24.86 % of cases. No correlation was found between the occurrence of complications and patient age, comorbidities, surgical indication, additional procedures performed during gastrostomy, or surgeon experience. However, laparoscopic gastrostomy was significantly correlated with peristomal leakage (p = 0.0002). We conducted long-term (at least three months) postoperative follow-up of 247 patients. Conclusions: This study highlights a significant correlation between laparoscopic gastrostomy and peristomal leakage. However, no standard or preferred technique for performing gastrostomy in children has been identified.