Strategy of reduced port gastrostomy as a safe procedure for paediatric patients.

IF 1 4区医学 Q3 SURGERY

Journal of Minimal Access Surgery Pub Date : 2025-04-08 DOI:10.4103/jmas.jmas_218_24

Yousuke Gohda, Hiroo Uchida, Takahisa Tainaka, Wataru Sumida, Chiyoe Shirota, Satoshi Makita, Miwa Satomi, Akihiro Yasui, Daiki Kato, Takuya Maeda, Hiroki Ishii, Kazuki Ota, Yaohui Guo, Jiahui Liu, Akinari Hinoki

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Abstract

Background: Laparoscopic gastrostomy has improved surgical and cosmetic outcomes. Our approach involves a strategy of reduced port surgery, wherein only the umbilicus and tube insertion site were incised, with an additional port inserted if manipulation is difficult. This study aimed to investigate the outcomes of our reduced port gastrostomy strategy.

Patients and methods: The paediatric patients who underwent gastrostomy at our institution from July 2013 to March 2023 were reviewed retrospectively. Surgical outcomes were compared between patients who underwent reduced port gastrostomy and those who underwent multiport gastrostomy with or without fundoplication.

Results: Of the 78 patients who underwent gastrostomy, 25 and 39 patients who underwent reduced port gastrostomy and multiport gastrostomy with or without fundoplication, respectively, were included. Five patients who underwent reduced port gastrostomy required an additional port. The operative time during gastrostomy was shorter in the multiport gastrostomy group (21.3 min vs. 17.2 min, P = 0.00). One splenic injury in the reduced port gastrostomy group and one split of the stomach in the multiport gastrostomy group occurred and were completely repaired intraoperatively. No patient required reoperation within 30 days after gastrostomy. Post-operative complications, such as infection with pus (1 vs. 2, P = 1.00), external leakage requiring nutritional management change or tube replacement (2 vs. 2, P = 0.64) and tube dislodgement (1 vs. 0, P = 0.39), were similar between the two groups.

Conclusions: The strategy of reduced port gastrostomy was safe and cosmetically favourable compared with multiport gastrostomy.

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小口胃造口术作为儿科患者安全手术的策略。

背景：腹腔镜胃造口术改善了手术和美容效果。我们的方法包括减少端口手术策略，其中仅切开脐和管插入部位，如果操作困难，则插入额外的端口。本研究旨在探讨我们的缩小胃造口策略的结果。患者和方法：回顾性分析2013年7月至2023年3月在我院行胃造口术的儿科患者。手术结果比较了行小口胃造口术的患者和行多口胃造口术的患者，有或没有底叠术。结果：78例行胃造口术的患者中，分别有25例和39例分别行小口胃造口术和多口胃造口术，伴有或不伴有胃底吻合。5例接受小口胃造口术的患者需要增加一个口。多孔胃造口组手术时间较短（21.3 min vs. 17.2 min, P = 0.00）。缩小胃造口组1例脾损伤，多口胃造口组1例胃裂，术中全部修复。无患者在胃造口术后30天内再次手术。术后并发症，如脓感染（1 vs. 2, P = 1.00），需要改变营养管理或更换管的外漏（2 vs. 2, P = 0.64）和管移位（1 vs. 0, P = 0.39），两组之间相似。结论：与多口胃造口术相比，小口胃造口术安全、美观。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Minimal Access Surgery SURGERY-

CiteScore

1.70

自引率

0.00%

发文量

151

审稿时长

36 weeks

期刊介绍： Journal of Minimal Access Surgery (JMAS), the official publication of Indian Association of Gastrointestinal Endo Surgeons, launched in early 2005. The JMAS, a quarterly publication, is the first English-language journal from India, as also from this part of the world, dedicated to Minimal Access Surgery. The JMAS boasts an outstanding editorial board comprising of Indian and international experts in the field.