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. 2017 Apr-Jun;13(2):81-88.
doi: 10.4103/0972-9941.181776.

Laparoscopic versus percutaneous endoscopic gastrostomy placement in children: Results of a systematic review and meta-analysis

Nutnicha Suksamanapun  1 , Femke A Mauritz  2 , Josephine Franken  1 , David C van der Zee  1 , Maud Ya van Herwaarden-Lindeboom  1
Affiliations

Laparoscopic versus percutaneous endoscopic gastrostomy placement in children: Results of a systematic review and meta-analysis

Nutnicha Suksamanapun et al. J Minim Access Surg. 2017 Apr-Jun.

Abstract

Background: Percutaneous endoscopic gastrostomy (PEG) and laparoscopic-assisted gastrostomy (LAG) are widely used in the paediatric population. The aim of this study was to determine which one of the two procedures is the most effective and safe method.

Methods: This systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses statement. Primary outcomes were success rate, efficacy of feeding, quality of life, gastroesophageal reflux and post-operative complications.

Results: Five retrospective studies, comparing 550 PEG to 483 LAG placements in children, were identified after screening 2347 articles. The completion rate was similar for both procedures. PEG was associated with significantly more adjacent bowel injuries (P = 0.047), early tube dislodgements (P = 0.02) and complications that require reintervention under general anaesthesia (P < 0.001). Minor complications were equally frequent after both procedures.

Conclusions: Because of the lack of well-designed studies, we have to be cautious in making definitive conclusions comparing PEG to LAG. To decide which type of gastrostomy placement is best practice in paediatric patients, randomised controlled trials comparing PEG to LAG are highly warranted.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flow-chart of literature search. PEG: Percutaneous endoscopic gastrostomy, LAG: Laparoscopic gastrostomy
Figure 2
Figure 2
Meta-analysis of adjacent bowel injury after percutaneous endoscopic gastrostomy versus laparoscopic gastrostomy. Risk ratios are shown with 95% confidence intervals (Mantel–Haenszel random effects model)
Figure 3
Figure 3
Meta-analysis of early tube dislodgement after percutaneous endoscopic gastrostomy versus laparoscopic gastrostomy. Risk ratios are shown with 95% confidence intervals (Mantel–Haenszel random effects model)
Figure 4
Figure 4
Meta-analysis of all reinterventions requiring general anaesthesia after percutaneous endoscopic gastrostomy versus laparoscopic gastrostomy. Risk ratios are shown with 95% confidence intervals (Mantel–Haenszel random effects model)
See this image and copyright information in PMC

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