Postoperative gastrostomy site leakage correlated to the dimension of the gastrostomy button in children

Abstract

The laparoscopic placement of gastrostomy buttons for feeding tubes is the preferred method of gastrostomy in children with feeding requirements. This intervention often leads to some minor postoperative problems, including gastrostomy site leakage. The aim of our study was to test the hypothesis that the postoperative leakage after a video-assisted gastrostomy is correlated to the dimension of the gastrostomy button used during the oper­ation. Included in the study were 164 children with nutritional problems who consecutively underwent surgery; they had a video-assisted gastrostomy operation. In the first 87 children, a 14 French (Fr) gastrostomy button was used and in the last 77, a 12 Fr button was used. After the operation, the children were followed up prospectively and all complications were documented according to the study protocol. Our study revealed a significant correlation between the dimension of the gastrostomy button and the postoperative leakage at the gastrostomy site. The rate of leakage at the gastrostomy site was 37% in the children who had 14 Fr gastrostomy buttons compared to 18% (P=0.038) in the children who had 12 Fr gastrostomy buttons, during the first six months postoperatively. These results suggest that postoperative gastrostomy site leakage was significantly higher in children who had 14 Fr gastrostomy buttons than in those with 12 Fr buttons. To avoid this complication, 12 Fr gastro­stomy buttons should be used.