Modified open technique for laparoscopic gastrostomy tube placement results in more leakage post operatively than Seldinger technique.
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In brief
In brief
This prospective study compared two laparoscopic gastrostomy tube placement techniques in 92 pediatric patients. The modified open technique resulted in significantly higher leakage rates (26.8%) compared to the Seldinger technique (5.6%), while other complications remained similar between groups.
Written by the GCMD Library team from the article.
BACKGROUND: Laparoscopic gastrostomy tube (GT) placement is a common procedure and frequent cause of morbidity. Some surgeons perform a Seldinger technique (ST), while others perform a modified open technique (MOT). We hypothesized that the modified open technique would result in more complications.
METHODS: A prospective study of primary GT placed 12/2016-06/2018, ensuring at least 6 months follow up. We assessed any episode of granulation tissue, troublesome leaking, tube dislodgment, and infection requiring antibiotic or drainage.
RESULTS: 92 GT were placed, with 56 were placed as modified open (60.9%). 34 children (37.0%) developed granulation tissue, 18 children (19.6%) experienced tube dislodgment, and 6 children (6.5%) developed a site infection, with no difference depending on technique (P = 0.56, 0.29, and 0.76, respectively). Following ST, 2 children developed leakage (5.6%), whereas 15 children (26.8%) had leakage following the MOT (P = 0.01).
CONCLUSION: MOT resulted in significantly more leaks. Other complications were similar between groups. Surgeons choosing MOT should be mindful of the size of gastrotomy at time of surgery, as this may result in increased complications.
doi: 10.1016/j.amjsurg.2019.07.023.