2023 Volume 59 Issue 6 Pages 965-972
Purpose: Gastrostomy has become a commonly used procedure for pediatric patients with swallowing difficulty and feeding disorder. The gastrostomy with excessive leakage sometimes requires reconstruction. This study was conducted to investigate related factors and important points to prevent excessive leakage around the gastrostomy in severely mentally and physically handicapped children.
Methods: We conducted a retrospective review of the cases of 218 pediatric patients who underwent gastrostomy between January 2003 and December 2021. Patients who underwent temporary gastrostomy for congenital gastrointestinal disease and those capable of oral intake were excluded from this study. The risk factors were evaluated using clinical archives.
Results: A total of 218 patients were identified. There was no mortality associated with the procedure. Six patients required gastrostomy reconstruction owing to excessive leakage around the gastrostomy after conservative treatment failed. The median interval between the initial gastrostomy and the reconstruction was 76 months (range: 43–158 months). The frequency of excessive leakage around the gastrostomy that required reconstruction was significantly lower in the laparoscope-assisted percutaneous endoscopic gastrostomy (LAPEG) group than in the Stamm gastrostomy group.
Conclusions: Excessive leakage around the gastrostomy is not a common complication but can occasionally become a serious problem in severely mentally and physically handicapped children. LAPEG could be recommended to prevent excessive leakage around the gastrostomy, and it is important to keep paying attention to the condition of the gastrostomy for a long period.
