A systematic review and meta-analysis of gastrostomy insertion techniques in children

Journal of Pediatric Surgery
Laura BakerRobert Baird

Abstract

Gastrostomy tubes are inserted via multiple techniques to provide a route for enteral feeding in the pediatric population. This review compares the rate of major complications and resource utilization associated with the various insertion techniques. Major electronic databases were queried for comparative studies of two or more insertion techniques, including open, laparoscopic, percutaneous endoscopic, or fluoroscopic guided. Major complications were defined as reoperation within 1 year or death. Screening of eligible studies, data extraction, and assessment of methodological quality were conducted independently by two reviewers. Forest and funnel plots were generated for outcomes using Revman 5.1, with p<0.05 considered significant. Twenty-two studies with a total of 5438 patients met inclusion criteria. No differences in major complications were noted in studies comparing open versus laparoscopic approaches or open versus PEG. Studies comparing laparoscopic gastrostomy and PEG revealed a significantly increased risk in major complications with PEG (n=10 studies, OR 0.29, 95% CI: 0.17-0.51, p<0.0001). The number needed to treat to reduce one major complication by abandoning PEG is 45. PEG is associated with an increased risk ...Continue Reading

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Citations

Sep 28, 2016·Journal of Pediatric Surgery·Ethan Charles Blocher-Smith, David A Smith
Sep 30, 2016·Journal of Pediatric Surgery·Rachel M LandischJohn C Densmore
Dec 22, 2017·Journal of Clinical Nursing·Ashleigh TownleyShauna Kingsnorth
Dec 2, 2017·Pediatric Emergency Care·Susan Fuchs
Nov 14, 2015·World Journal of Clinical Pediatrics·Abdulkerim Temiz
Jan 10, 2018·Clinical Endoscopy·Francesco MacchiniErnesto Leva
Dec 12, 2017·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Mete KayaEsra Ozcakir
Jul 14, 2018·Current Opinion in Pediatrics·Andrea Volpe, Georgina Malakounides
Mar 12, 2019·Pediatric Blood & Cancer·Kathleen H McGrath, Winita Hardikar
Sep 29, 2019·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Ashwath S KumarThomas Mario Attard
Jul 6, 2017·Journal of Pediatric Hematology/oncology·Emma C HamiltonMary T Austin
May 4, 2017·Annals of the Royal College of Surgeons of England·R PeeraullyB Davies
Jul 23, 2020·Developmental Medicine and Child Neurology·Ellen Backman, Lotta Sjögreen
Feb 8, 2020·Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association·Osama A Bawazir
Jul 1, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Sara L ZettervallKhashayar Vaziri
Mar 23, 2019·Pediatric Gastroenterology, Hepatology & Nutrition·Ivana Trivić, Iva Hojsak
Sep 26, 2019·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Hector OseiGustavo A Villalona
Jun 5, 2020·Children·Jose H SalazarKyle J Van Arendonk
Nov 3, 2020·International Journal of Pediatrics·Fayza HaiderShahraban Abdulla Juma
Aug 3, 2020·Journal of Pediatric Gastroenterology and Nutrition·Joseph R DavidsonIain E Yardley
May 3, 2021·Journal of Pediatric Surgery·Claudia KohDavid J Wilkinson
Jul 11, 2021·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·James EvansJulie Lanigan
Sep 15, 2020·Journal of Pediatric Surgery·Yew-Wei TanPaul Charlesworth
Sep 16, 2021·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Berat Dilek DemirelGonul Caltepe
Jul 15, 2021·Journal of Pediatric Gastroenterology and Nutrition·Maireade E McSweeneyRachel Rosen
Nov 9, 2021·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Rebecca A SaberiChad M Thorson
Nov 18, 2021·Journal of Veterinary Internal Medicine·Melanie D Craven

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