Gastrostomy in childhood. Problems and complications

Background. Pediatric gastrostomy is performed either via an open laparoscopic or endoscopic approach. Problems and complications are frequent in pediatric gastrostomy irrespective of the chosen procedure. This article gives a 5-year retrospective review focusing on the major and minor complications of this apparently routine intervention and proposes the safest possible procedure for pediatric gastrostomy. Material and methods. A retrospective medical chart review of gastrostomy in children from 2009 to 2013 was carried out at the department of pediatric surgery. The indications, techniques and complications were compared. Results. A total of 62 gastrostomies were performed in 60 patients and 7 major and 9 minor complications were found. All major complications occurred in patients who underwent open surgical gastrostomy or percutaneous endoscopic gastrostomy (PEG). In laparoscopic gastrostomy only minor complications occurred. Discussion. The overall complication rate in pediatric gastrostomy is high. Major complications are more frequent with PEG. Open gastrostomy may be necessary in specific cases. With the introduction of laparoscopic gastrostomy as a routine procedure, major complications could be prevented. Conclusion. Laparoscopic gastrostomy is recommended as the method of choice in pediatric patients.