Department of Pediatric Surgery, Connecticut Children's Medical Center, Hartford, CT, USA.
J Pediatr Surg. 2019 Nov;54(11):2453-2456. doi: 10.1016/j.jpedsurg.2019.06.024. Epub 2019 Jul 5.
BACKGROUND/PURPOSE: Laparoscopic gastrostomy (LG) and percutaneous endoscopic gastrostomy (PEG) are two common methods for gastrostomy feeding tube placement in children. There have been limited studies evaluating these surgical interventions in infants under 12 months of age.
This study is a retrospective review of 186 patients who underwent either LG or PEG placement over a 5-year period at a single institution. The primary outcome for this study was the complication rate between the two groups.
Of 186 patients who underwent gastrostomy tube placements, n = 130 patients comprised the PEG cohort, and n = 56 made up the LG cohort. The demographics of the two cohorts were comparable in weight, age, and co-morbidities. The overall complication rate was 29.6% The breakdown of 31.5% complications in the PEG group vs. 25% in the laparoscopic group was not statistically different. However, the PEG group did have significantly more patients who required general anesthetic for additional procedures related to G tube placement.
Laparoscopy and endoscopy are both acceptable options for gastrostomy tube placements in infants. However, this study identifies that PEG placements are associated with significantly increased risk for the need of additional procedures requiring general anesthesia in this patient population.
背景/目的：腹腔镜胃造口术（LG）和经皮内镜胃造口术（PEG）是儿童胃造口喂养管放置的两种常见方法。对于 12 个月以下的婴儿，这些手术干预措施的评估研究有限。
本研究回顾性分析了在一家机构接受 LG 或 PEG 放置的 186 名患者，时间跨度为 5 年。本研究的主要结局是两组之间的并发症发生率。
在接受胃造口管放置的 186 名患者中，n=130 名患者为 PEG 组，n=56 名患者为 LG 组。两组的人口统计学数据在体重、年龄和合并症方面具有可比性。总体并发症发生率为 29.6%。PEG 组的并发症发生率为 31.5%，腹腔镜组为 25%，两组之间的差异无统计学意义。然而，PEG 组确实有更多的患者需要全身麻醉来进行与 G 管放置相关的额外手术。
腹腔镜和内镜都是婴儿胃造口管放置的可接受选择。然而，本研究表明，PEG 放置与该患者群体中需要全身麻醉的额外手术的风险显著增加相关。
