COMPARISON OF OPEN AND LAPAROSCOPIC GASTROSTOMY AND FUNDOPLICATION IN120 PATIENTS

The rapid development and incorporation of minimally invasive surgical techniques has abruptly changed adult surgical practices. These minim ally invasive procedures are now being successfully applied to pediatr ic surgical problems. The anticipated benefits of these techniques inc lude less postoperative pain, quicker return of bower function, shorte r hospital stay, and lower hospital costs, with a quicker return to no rmal activity. This report compares the first 60 infants and children to undergo laparoscopic gastrostomy and/or fundoplication at our insti tution with the same number of patients that underwent these procedure s in the traditional open fashion. The two groups were similar with re spect to age, sex, concurrent illness, presenting symptoms, neurologic al status, and procedures performed. Patients in the laparoscopic grou p were found to have shorter mean hospital and postoperative stays and tolerated feeding earlier. The mean hospital stay was 13.8 days for t he laparoscopic group versus 16.4 days in the open group. The mean pos toperative stay was 6.8 days for the laparoscopic group versus 10.7 da ys for the open group. The mean postoperative day on which feeding was tolerated was 2.3 in the laparoscopic group versus 4.8 in the open gr oup. Postoperative complications were similar between the two groups. These results seem to reflect the less traumatic nature of the laparos copic procedures as compared with the open procedures. Laparoscopic fu ndoplication and gastrostomy is an attractive alternative to open fund oplication and gastrostomy in infants and children. Copyright (C) 1995 by W.B. Saunders Company