Same-Day Discharge for Elective Pediatric Laparoscopic Gastrostomy Tube Insertion is Safe and Increasing in Frequency | ACS NSQIP-P registry | Retrospective review | 2017 - 2021 | 5947 patients | elective pediatric laparoscopic gastrostomy | Post-op same-day discharge (SDD) vs Discharged at 1-2 days (non-SDD) | No significant differences between SDD and non-SDD for... | Early readmission (0.7% vs 0.3%, p = 0.279) | 30-day unplanned readmission (8.5% vs 8.0%, p = 0.407) | Reoperation (0.1% vs 1.4%, p = 1.000) | The annual rate of SDD over 5 years increased: 2.7% to 4.5%-6.3% | Conclusion: Same-day discharge after pediatric gastrostomy is increasing annually, with no significant outcome differences for elective cases. It appears safe for non-steroid-using patients undergoing laparoscopic gastrostomy. | https://pubmed.ncbi.nlm.nih.gov/39261186/ | Woodward JM et. al. | University at Buffalo Division of Pediatric Surgery, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY | Journal of Pediatric Surgery | @EmGooteeMD | @StayCurrentMD | Cincinnati Children's
Same-Day Discharge for Elective Pediatric Laparoscopic Gastrostomy Tube Insertion is Safe and Increasing in Frequency; A NSQIP Pediatric Retrospective Review 2017 to 2021
Infographic · Feb 2025 · 1 min read
In brief
In brief
NSQIP-P analysis of 5,947 elective pediatric laparoscopic gastrostomy cases (2017-2021) shows same-day discharge rates doubled from 2.7% to 6.3% without increased readmissions or complications. Preoperative steroid use doubled complication risk, but non-steroid patients can safely undergo same-day discharge after laparoscopic G-tube placement.
- Same-day discharge after pediatric laparoscopic G-tube is safe with no increase in 30-day readmission or reoperation rates (8.5% vs 8.0%).
- National same-day discharge rates doubled from 2.7% to 6.3% between 2017-2021, indicating growing acceptance of outpatient approach.
- Preoperative steroid use doubles risk of complications (OR 2.02) and readmission (OR 2.10)—consider overnight observation in this group.
- All patients requiring reoperation within 3 days showed signs before discharge, supporting feasibility of same-day protocols with proper monitoring.
- In steroid-naive elective cases, same-day discharge is a viable option to reduce healthcare costs and family burden without compromising safety.
Written by the GCMD Library team from the infographic.
The infographic uses a teal and yellow color scheme with the ACS NSQIP logo on the left. Key statistics are displayed in large text on a teal background, with outcome comparisons shown in bullet points. An upward arrow illustrates the increasing trend in same-day discharge rates. A cartoon illustration in the bottom right shows three smiling figures representing healthcare providers and a patient.
John M. Woodward, Caitlin Chunco, Stephanie F. Brierley, Krystle Bittner, Hector Osei, Carroll M. Harmon, P. Benson Ham, III
Background: There is limited literature reviewing same-day discharge for elective pediatric gastrostomy tube placement. Our aim was to assess the outcomes and national trends of same-day discharge following elective pediatric laparoscopic gastrostomy.
Methods: ACS NSQIP-P registry data from 2017 to 2021 was used to evaluate elective pediatric laparoscopic gastrostomy patients who presented from home and discharged home with a diagnosis of failure to thrive, feeding difficulty or dysphagia. Patients discharged same-day postoperatively (SDD) were compared to those discharged 1-2 days postoperatively (non-SDD) for the primary outcome of unplanned 30-day readmission. Secondary outcomes included bleeding events, wound infection, and 30-day reoperation.
Results: There were 5,947 patients identified; 4.7% were discharged same-day. The annual rate of SDD over 5 years went from 2.7% to 4.6%-4.8% to 4.5%-6.3%. There were no significant differences between SDD and non-SDD patients for early readmission or reoperation (0.7% vs 0.3%, p = 0.279), 30-day unplanned readmission (8.5% vs 8.0%, p = 0.407), reoperation (0.1% vs 1.4%, p = 1.000), or any other complications (p > 0.05). Binary logistic regression found pre-operative steroid use within 30 days increased risk of serious complication (OR 2.02, 95% CI 1.29-3.15, p = 0.002) and 30-day readmission or reoperation (OR 2.10, 95% CI 1.34-3.27, p = 0.001). All 6 patients (0.1%) who required reoperation within 3 days were identified prior to discharge, and none of the 16 patients readmitted within 3 days of surgery required reoperation.
Conclusion: Though rates of same-day discharge following pediatric gastrostomy tube placement are low, they continue to increase annually. There were no significant differences in outcomes between same-day and non-same-day day discharge for elective cases presenting from and discharging home. In non-steroid using patients, same-day discharge following laparoscopic gastrostomy can be a safe option.