Complications of laparoscopy-aided gastrostomies in pediatric practice.

PURPOSE: The aim of this report is to establish the frequency and type of complications of laparoscopy-aided gastrostomy in pediatric practice and to identify patients at risk for postoperative complications.

METHOD: This is a follow-up study of 98 children with nutritional problems including inability to swallow, inadequate calorie intake in neurologically impaired children, patients with cystic fibrosis, malignancies, neurometabolic diseases, and cardiac malformations. Laparoscopy-aided gastrostomy was attempted in all patients. These patients have undergone follow-up at our outpatient clinic. Postoperative complications and problems with the gastrostomy device were registered. The postoperative complications were divided into minor problems and major or life-threatening complications.

RESULTS

There was no perioperative mortality. No life-threatening complication developed, whereas minor problems were common, necessitating medical attention postoperatively. Patients with congenital heart disease, chronic respiratory failure, and metabolic diseases experienced the highest frequency of postoperative complications.

CONCLUSIONS

The surgical placement of an enteral access device in children should be considered a major surgical procedure, demanding medical attention for 1 to 2 months postoperatively. The rate and severity of complications with the method described are tolerable considering the severity of the underlying diseases.