Complications of laparoscopy-aided gastrostomies in pediatric practice

Purpose: The aim of this report is to establish the frequency and type of c omplications 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, neurometab olic 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 gastro stomy 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 complica tion developed, whereas minor problems were common, necessitating medical a ttention postoperatively. Patients with congenital heart disease, chronic r espiratory failure, and metabolic diseases experienced the highest frequenc y of postoperative complications. Conclusions: The surgical placement of an enteral access device in children should be considered a major surgical procedure, demanding medical attenti on for 1 to 2 months postoperatively. The rate and severity of complication s with the method described are tolerable considering the severity of the u nderlying diseases. J Pediatr Surg 34:1843-1846. Copyright (C) 1999 by W.B. Saunders Company.