Outcomes of the Basic Laparoscopic Stamm Gastrostomy Technique With or Without Fundoplication in Children.

Background

Various methods for gastrostomy tube (GT) placement have been described, including open, endoscopic, and laparoscopic. We present the results of the basic laparoscopic Stamm gastrostomy (LSG) method that we recently described.

Methods

Data of patients who underwent gastrostomy with the LSG method between 2016 and 2024 were retrospectively analyzed. The patients were divided into two groups as those who had only LSG and those who had fundoplication in the same session. Primary endpoints included demographic and clinical characteristics, operative findings, and minor and major postoperative complications.

Results

During the study period, LSG was performed in 122 patients (M/F: 68/54, median age: 2.5 years), only gastrostomy in 9 patients and with concomitant fundoplication in 113 patients. Both age and weight were significantly lower in the LSG group (P < 0.05). Most of patients have neurological impairment (79%). The gastrostomy indications were failure to thrive (53%) and gastroesophageal reflux symptoms (38%). There were no conversions to open surgery and no complications. The median duration of the procedure in gastrostomy, and with fundoplication was 30 and 95 minutes, respectively, the difference was significant (P < 0.05). The mean follow-up period was 63 months. Minor complications such as granulation, leakage, and dislocation were developed in 63 patients (52%), and adhesive bowel obstruction or peritonitis as major complications in 4 patients (4%).

Conclusion

The LSG method is a safe, effective, and durable minimally invasive method with satisfactory midterm follow-up results and a low complication rate in patients with neurological disorders and those requiring gastrostomy due to other pathologies.