Thompson David, Allam Maddie, Dick Karen, Leigh Jo, Taylor Rhoda, Keys Charlie, Kitteringham Lara, Ron Ori, Stanton Michael, Stedman Francesca, Hall Nigel J
Department of Paediatric Surgery and Urology, Southampton Children's Hospital, Southampton, UK.
University Surgery Unit, University of Southampton, Southampton, UK.
Pediatr Surg Int. 2025 Jan 24;41(1):72. doi: 10.1007/s00383-024-05929-0.
Recent efforts have sought to streamline gastrostomy insertion care, particularly length of stay (LOS). We report our initial experience with day-case gastrostomy (DCG) insertion.
Retrospective review (April 2018-2024) of all primary gastrostomy insertions. Patients discharged the same day as the procedure were defined as DCG. Demographic, operative, and clinical data were recorded. All cases were treated according to a standardized feeding pathway.
Of 432 gastrostomies formed, 15 were DCG; median age 3.5 (0.7-16.9) years, LOS 12 h (9-15 h). The most common indication was nutritional supplementation (n = 9). Gastrostomy technique was single-stage percutaneous rapid insertion of gastrostomy button (SPRING n = 5) or percutaneous endoscopic gastrostomy (PEG n = 10). Prior to insertion, 6/15 DCG were established on nasogastric (NG) feeding, 8 did not use NG feeding, and 1 had occasional NG feeds. The majority (13/15) were performed on morning operating lists. There were 4 minor complications; 2 required readmission.
DCG in selected cases is feasible and safe. Most cases were performed on morning operating list, but fewer than half had prior experience of nasogastric tube feeding. We suggest additional pathway modifications to improve DCG uptake.
最近的努力旨在简化胃造口术插入护理，尤其是住院时间（LOS）。我们报告了我们日间胃造口术（DCG）插入的初步经验。
对所有原发性胃造口术插入进行回顾性研究（2018年4月至2024年）。手术当天出院的患者被定义为DCG。记录人口统计学、手术和临床数据。所有病例均按照标准化喂养途径进行治疗。
在432例胃造口术中，15例为DCG；中位年龄3.5岁（0.7 - 16.9岁），住院时间12小时（9 - 15小时）。最常见的指征是营养补充（n = 9）。胃造口术技术为单阶段经皮快速插入胃造口纽扣（SPRING，n = 5）或经皮内镜胃造口术（PEG，n = 10）。插入前，15例DCG中有6例已通过鼻胃管（NG）喂养，8例未使用NG喂养，1例偶尔使用NG喂养。大多数（13/15）在上午手术安排中进行。有4例轻微并发症；2例需要再次入院。
在选定病例中，DCG是可行且安全的。大多数病例在上午手术安排中进行，但不到一半的患者有鼻胃管喂养的既往经验。我们建议进一步改进途径以提高DCG的接受度。
