Endoscopic button gastrostomy: Comparing a sutured endoscopic approach to the current techniques

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• 作者：Jessica Gonzalez-Hernandez^a ; Yahya Daoud^a ; Anne C. Fischer^b ; Bradley Barth^c ; Hannah G. Piper^d ; ^{Hannah.Piper@childrens.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Button gastrostomy ; Percutaneous endoscopic gastrostomy ; Laparoscopic gastrostomy
• 刊名：Journal of Pediatric Surgery
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：51
• 期：1
• 页码：72-75
• 全文大小：378 K

文摘

Button gastrostomy is the preferred feeding device in children and can be placed open or laparoscopically (LBG). Alternatively, a percutaneous endoscopic gastrostomy (PEG) can be placed initially and exchanged for a button. Endoscopic-assisted button gastrostomy (EBG) combines both techniques, using only one incision and suturing the stomach to the abdominal wall. The long-term outcomes and potential costs for EBG were compared to other techniques.

Methods

Children undergoing EBG, LBG, and PEG (2010–2013) were compared. Patient demographics, procedure duration/complications, and clinic and emergency room (ER) visits for an eight-week follow-up period were compared.

Results

Patient demographics were similar (32 patients/group). Mean procedure time (min) for EBG was 38 ± 9, compared to 58 ± 20 for LBG and 31 ± 10 for PEG (p < 0.0001). The most common complications were granulation tissue and infection with a trend toward fewer infections in EBG group. Average number of ER visits was similar, but PEG group had fewer clinic visits. 97% of PEG patients had subsequent visits for exchange to button gastrostomy.

Conclusions

EBG is safe and comparable to LBG and PEG in terms of complications. It has a shorter procedure time than LBG and does not require laparoscopy, device exchange, or subsequent fluoroscopic confirmation, potentially reducing costs.