TY - JOUR
T1 - Elective laparoscopic gastrostomy in children
T2 - potential for an enhanced recovery protocol
AU - Williams, Kibileri
AU - Baumann, Lauren
AU - Abdullah, Fizan
AU - Hendrickson, Richard J.
AU - Oyetunji, Tolulope A.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Purpose: Gastrostomy tube placement is one of the most commonly performed pediatric surgical procedures and discharge is possible as early as the first postoperative day with early initiation of feeds postoperatively. We examined a national database to determine hospital length of stay (LOS) after elective laparoscopic gastrostomy in children. Methods: We queried the 2012–2013 National Surgical Quality Improvement Program Pediatric (NSQIP-P) database, including all patients who underwent elective laparoscopic gastrostomy tube placement for failure to thrive or feeding difficulties. Demographic data, admission status, disposition at discharge, surgical subspecialty data and hospital LOS were extracted. Results: A total of 599 patients underwent gastrostomy tube placement for failure to thrive or feeding intolerance. The majority, 52%, was male and 69.3% were White. The median age was 2.2 years (IQR 0.9–6.3). Of the total, 28.7% were infants. The median total hospital LOS was 2 days (IQR 1–2), with only 39% discharged in a day or less. Conclusion: Pediatric patients undergoing elective laparoscopic gastrostomy have a median hospital length of stay of 2 days, despite evidence that early feeding and discharge within 24 h is both feasible and safe. There is potential for the implementation of an enhanced recovery protocol as a quality metric for this procedure.
AB - Purpose: Gastrostomy tube placement is one of the most commonly performed pediatric surgical procedures and discharge is possible as early as the first postoperative day with early initiation of feeds postoperatively. We examined a national database to determine hospital length of stay (LOS) after elective laparoscopic gastrostomy in children. Methods: We queried the 2012–2013 National Surgical Quality Improvement Program Pediatric (NSQIP-P) database, including all patients who underwent elective laparoscopic gastrostomy tube placement for failure to thrive or feeding difficulties. Demographic data, admission status, disposition at discharge, surgical subspecialty data and hospital LOS were extracted. Results: A total of 599 patients underwent gastrostomy tube placement for failure to thrive or feeding intolerance. The majority, 52%, was male and 69.3% were White. The median age was 2.2 years (IQR 0.9–6.3). Of the total, 28.7% were infants. The median total hospital LOS was 2 days (IQR 1–2), with only 39% discharged in a day or less. Conclusion: Pediatric patients undergoing elective laparoscopic gastrostomy have a median hospital length of stay of 2 days, despite evidence that early feeding and discharge within 24 h is both feasible and safe. There is potential for the implementation of an enhanced recovery protocol as a quality metric for this procedure.
KW - Laparoscopic gastrostomy
KW - Length of stay
KW - Pediatric
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U2 - 10.1007/s00383-019-04472-7
DO - 10.1007/s00383-019-04472-7
M3 - Article
C2 - 30915530
AN - SCOPUS:85064151620
JO - Pediatric Surgery International
JF - Pediatric Surgery International
SN - 0179-0358
ER -