Gastrostomy insertion in the 21st century: PEG or laparoscopic? Report from a large single-centre series
Purpose To determine whether laparoscopic-assisted gastrostomy (LAG) has superseded percutaneous endoscopic gastrostomy (PEG) based on the clinical outcomes. Methods A retrospective study was undertaken for the period January 06–December 09. Demographic and clinical outcomes were recorded and the tw...
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| Veröffentlicht in: | Pediatric surgery international 2012-05, Vol.28 (5), p.443-448 |
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| creator | Wragg, Ruth Clare Salminen, Heidi Pachl, Max Singh, Michael Lander, Anthony Jester, Ingo Parikh, Dakshesh Jawaheer, Girish |
| description | Purpose
To determine whether laparoscopic-assisted gastrostomy (LAG) has superseded percutaneous endoscopic gastrostomy (PEG) based on the clinical outcomes.
Methods
A retrospective study was undertaken for the period January 06–December 09. Demographic and clinical outcomes were recorded and the two groups were compared.
Results
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 (
p
|
| doi_str_mv | 10.1007/s00383-012-3079-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1009534233</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2784866361</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-91682f7cf02eac0139429c390b41aa3526a0401e111450712e7b74084e565bcf3</originalsourceid><addsrcrecordid>eNp1kU1r3DAQhkVpaLZpf0AvRdBLLm5m9GFZuZQQkm0gkFDas9Gq442DbbmSfNh_Hy2bllDISR_zvO9I8zL2CeErApizBCAbWQGKSoKxlX7DVqikqWyD8i1bAZZLkLo5Zu9TegSARtb2HTsWQpnaoFqxh7VLOYaUw7jj_ZQo5j5MZcfzA3GBKXNPU17i7pzfX615iHxwsysKH-bef-M_aA4x8y6GkbtSi1viqZ-2A1V7YSwnij2lD-yoc0Oij8_rCft1ffXz8nt1e7e-uby4rbw0IlcW60Z0xncgyHlAaZWwXlrYKHROalE7UICEiEqDQUFmYxQ0inStN76TJ-z04DvH8GehlNuxT56GwU0UltSWwVktlZCyoF_-Qx_DEqfyukJZrU0jhC0UHihfPp0ide0c-9HFXYH2bqY9xNCWGNp9DK0ums_PzstmpN__FH_nXgBxAFIpTVuKL1u_5voEY8OQrQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1095578229</pqid></control><display><type>article</type><title>Gastrostomy insertion in the 21st century: PEG or laparoscopic? Report from a large single-centre series</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Wragg, Ruth Clare ; Salminen, Heidi ; Pachl, Max ; Singh, Michael ; Lander, Anthony ; Jester, Ingo ; Parikh, Dakshesh ; Jawaheer, Girish</creator><creatorcontrib>Wragg, Ruth Clare ; Salminen, Heidi ; Pachl, Max ; Singh, Michael ; Lander, Anthony ; Jester, Ingo ; Parikh, Dakshesh ; Jawaheer, Girish</creatorcontrib><description>Purpose
To determine whether laparoscopic-assisted gastrostomy (LAG) has superseded percutaneous endoscopic gastrostomy (PEG) based on the clinical outcomes.
Methods
A retrospective study was undertaken for the period January 06–December 09. Demographic and clinical outcomes were recorded and the two groups were compared.
Results
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 (
p
< 0.001). 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.
Conclusion
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.</description><identifier>ISSN: 0179-0358</identifier><identifier>EISSN: 1437-9813</identifier><identifier>DOI: 10.1007/s00383-012-3079-5</identifier><identifier>PMID: 22476714</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adolescent ; Child ; Child, Preschool ; Enteral Nutrition ; Female ; Gastroscopy - methods ; Gastrostomy - methods ; Humans ; Infant ; Laparoscopy - methods ; Length of Stay - statistics & numerical data ; Male ; Medicine ; Medicine & Public Health ; Original Article ; Pediatric Surgery ; Pediatrics ; Postoperative Complications ; Prospective Studies ; Retrospective Studies ; Statistics, Nonparametric ; Surgery ; Suture Techniques ; Treatment Outcome</subject><ispartof>Pediatric surgery international, 2012-05, Vol.28 (5), p.443-448</ispartof><rights>Springer-Verlag 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-91682f7cf02eac0139429c390b41aa3526a0401e111450712e7b74084e565bcf3</citedby><cites>FETCH-LOGICAL-c372t-91682f7cf02eac0139429c390b41aa3526a0401e111450712e7b74084e565bcf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00383-012-3079-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00383-012-3079-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22476714$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wragg, Ruth Clare</creatorcontrib><creatorcontrib>Salminen, Heidi</creatorcontrib><creatorcontrib>Pachl, Max</creatorcontrib><creatorcontrib>Singh, Michael</creatorcontrib><creatorcontrib>Lander, Anthony</creatorcontrib><creatorcontrib>Jester, Ingo</creatorcontrib><creatorcontrib>Parikh, Dakshesh</creatorcontrib><creatorcontrib>Jawaheer, Girish</creatorcontrib><title>Gastrostomy insertion in the 21st century: PEG or laparoscopic? Report from a large single-centre series</title><title>Pediatric surgery international</title><addtitle>Pediatr Surg Int</addtitle><addtitle>Pediatr Surg Int</addtitle><description>Purpose
To determine whether laparoscopic-assisted gastrostomy (LAG) has superseded percutaneous endoscopic gastrostomy (PEG) based on the clinical outcomes.
Methods
A retrospective study was undertaken for the period January 06–December 09. Demographic and clinical outcomes were recorded and the two groups were compared.
Results
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 (
p
< 0.001). 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.
Conclusion
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.</description><subject>Adolescent</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Enteral Nutrition</subject><subject>Female</subject><subject>Gastroscopy - methods</subject><subject>Gastrostomy - methods</subject><subject>Humans</subject><subject>Infant</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Postoperative Complications</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Statistics, Nonparametric</subject><subject>Surgery</subject><subject>Suture Techniques</subject><subject>Treatment Outcome</subject><issn>0179-0358</issn><issn>1437-9813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1r3DAQhkVpaLZpf0AvRdBLLm5m9GFZuZQQkm0gkFDas9Gq442DbbmSfNh_Hy2bllDISR_zvO9I8zL2CeErApizBCAbWQGKSoKxlX7DVqikqWyD8i1bAZZLkLo5Zu9TegSARtb2HTsWQpnaoFqxh7VLOYaUw7jj_ZQo5j5MZcfzA3GBKXNPU17i7pzfX615iHxwsysKH-bef-M_aA4x8y6GkbtSi1viqZ-2A1V7YSwnij2lD-yoc0Oij8_rCft1ffXz8nt1e7e-uby4rbw0IlcW60Z0xncgyHlAaZWwXlrYKHROalE7UICEiEqDQUFmYxQ0inStN76TJ-z04DvH8GehlNuxT56GwU0UltSWwVktlZCyoF_-Qx_DEqfyukJZrU0jhC0UHihfPp0ide0c-9HFXYH2bqY9xNCWGNp9DK0ums_PzstmpN__FH_nXgBxAFIpTVuKL1u_5voEY8OQrQ</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Wragg, Ruth Clare</creator><creator>Salminen, Heidi</creator><creator>Pachl, Max</creator><creator>Singh, Michael</creator><creator>Lander, Anthony</creator><creator>Jester, Ingo</creator><creator>Parikh, Dakshesh</creator><creator>Jawaheer, Girish</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20120501</creationdate><title>Gastrostomy insertion in the 21st century: PEG or laparoscopic? Report from a large single-centre series</title><author>Wragg, Ruth Clare ; Salminen, Heidi ; Pachl, Max ; Singh, Michael ; Lander, Anthony ; Jester, Ingo ; Parikh, Dakshesh ; Jawaheer, Girish</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-91682f7cf02eac0139429c390b41aa3526a0401e111450712e7b74084e565bcf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Enteral Nutrition</topic><topic>Female</topic><topic>Gastroscopy - methods</topic><topic>Gastrostomy - methods</topic><topic>Humans</topic><topic>Infant</topic><topic>Laparoscopy - methods</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Postoperative Complications</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Statistics, Nonparametric</topic><topic>Surgery</topic><topic>Suture Techniques</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wragg, Ruth Clare</creatorcontrib><creatorcontrib>Salminen, Heidi</creatorcontrib><creatorcontrib>Pachl, Max</creatorcontrib><creatorcontrib>Singh, Michael</creatorcontrib><creatorcontrib>Lander, Anthony</creatorcontrib><creatorcontrib>Jester, Ingo</creatorcontrib><creatorcontrib>Parikh, Dakshesh</creatorcontrib><creatorcontrib>Jawaheer, Girish</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric surgery international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wragg, Ruth Clare</au><au>Salminen, Heidi</au><au>Pachl, Max</au><au>Singh, Michael</au><au>Lander, Anthony</au><au>Jester, Ingo</au><au>Parikh, Dakshesh</au><au>Jawaheer, Girish</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gastrostomy insertion in the 21st century: PEG or laparoscopic? Report from a large single-centre series</atitle><jtitle>Pediatric surgery international</jtitle><stitle>Pediatr Surg Int</stitle><addtitle>Pediatr Surg Int</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>28</volume><issue>5</issue><spage>443</spage><epage>448</epage><pages>443-448</pages><issn>0179-0358</issn><eissn>1437-9813</eissn><abstract>Purpose
To determine whether laparoscopic-assisted gastrostomy (LAG) has superseded percutaneous endoscopic gastrostomy (PEG) based on the clinical outcomes.
Methods
A retrospective study was undertaken for the period January 06–December 09. Demographic and clinical outcomes were recorded and the two groups were compared.
Results
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 (
p
< 0.001). 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.
Conclusion
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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22476714</pmid><doi>10.1007/s00383-012-3079-5</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0179-0358 |
| ispartof | Pediatric surgery international, 2012-05, Vol.28 (5), p.443-448 |
| issn | 0179-0358 1437-9813 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adolescent Child Child, Preschool Enteral Nutrition Female Gastroscopy - methods Gastrostomy - methods Humans Infant Laparoscopy - methods Length of Stay - statistics & numerical data Male Medicine Medicine & Public Health Original Article Pediatric Surgery Pediatrics Postoperative Complications Prospective Studies Retrospective Studies Statistics, Nonparametric Surgery Suture Techniques Treatment Outcome |
| title | Gastrostomy insertion in the 21st century: PEG or laparoscopic? Report from a large single-centre series |
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