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Open Access 01-07-2017 | Original Article

The Effect of Gastrostomy Placement on Gastric Function in Children: a Prospective Cohort Study

Authors: Josephine Franken, Femke A. Mauritz, Rebecca K. Stellato, David C. Van der Zee, Maud Y. A. Van Herwaarden-Lindeboom

Published in: Journal of Gastrointestinal Surgery | Issue 7/2017

Abstract

Background

A gastrostomy placement is frequently performed in pediatric patients who require long-term enteral tube feeding. Unfortunately, postoperative complications such as leakage, feeding intolerance, and gastroesophageal reflux frequently occur. These complications may be due to postoperative gastric dysmotility. Our aim was to evaluate the effect of gastrostomy placement on gastric emptying in children.

Methods

A prospective study was performed including 50 children undergoing laparoscopic gastrostomy. Before and 3 months after gastrostomy, assessment was performed using the ¹³C-octanoic acid breath test, 24-h pH monitoring, and reflux symptom questionnaires.

Results

Gastric half-emptying time significantly increased from the 57th to the 79th percentile (p < 0.001) after gastrostomy (p < 0.001). Fifty percent of patients with normal preoperative gastric emptying develop delayed gastric emptying (DGE, P > 95) after gastrostomy (p = 0.01). Most patients (≥75%) with leakage and/or feeding intolerance after gastrostomy had DGE after operation. A decrease in gastric emptying was associated with an increase in esophageal acid exposure time (r = 0.375, p < 0.001).

Conclusion

Gastrostomy placement in children causes a significant delay in gastric emptying. Postoperative DGE was associated with gastroesophageal reflux and was found in most patients with postoperative leakage and feeding intolerance. These negative physiologic effects should be taken into account when considering gastrostomy placement in children.

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Title: The Effect of Gastrostomy Placement on Gastric Function in Children: a Prospective Cohort Study
Authors: Josephine Franken
Femke A. Mauritz
Rebecca K. Stellato
David C. Van der Zee
Maud Y. A. Van Herwaarden-Lindeboom
Publication date: 01-07-2017
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 7/2017
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-017-3376-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

The Effect of Gastrostomy Placement on Gastric Function in Children: a Prospective Cohort Study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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