Background. The aim of this study was to determine the incidence of pre- and postoperative vomiting in children undergoing a Video-Assisted Gastrostomy (VAG) operation. Patients and Methods. 180 children underwent a VAG operation and were subdivided into groups based on their underlying diagnosis. An anamnesis with respect to vomiting was taken from each of the children's parents before the operation. After the VAG operation, all patients were followed prospectively at one and six months after surgery. All complications including vomiting were documented according to a standardized protocol. Results. Vomiting occurred preoperatively in 51 children (28%). One month after surgery the incidence was 43 (24%) in the same group of children and six months after it was found in 40 (22%). There was a difference in vomiting frequency both pre- and postoperatively between the children in the groups with different diagnoses included in the study. No difference was noted in pre- and postoperative vomiting frequency within each specific diagnosis group. Conclusion. The preoperative vomiting symptoms persisted after the VAG operation. Neurologically impaired children had a higher incidence of vomiting than patients with other diagnoses, a well-known fact, probably due to their underlying diagnosis and not the VAG operation. This information is useful in preoperative counselling.
Gastrostomy tube placements in children are associated with frequent postoperative complications. Children with gastrostomy tubes are frequent visitors to the emergency department and outpatient clinic. The aim of this study was to determine the incidence of postoperative gastrostomy complications and disclose if these were correlated to the patients' age and diagnosis. This is a prospective study of children who had undergone laparoscopic gastrostomy tube placement from June 2006 through March 2011. Patient demographics, comorbidities, and complications were collected. Data were analyzed by Fisher's exact test. P<0.05 is considered significant. One hundred and sixty-two children were evaluated, with the majority of patients <2 years of age (106/162). All the patients had undergone laparoscopic-assisted gastrostomy with double U-stitch technique. Granulation tissue, vomiting, infection, leakage were the most common postoperative complications. The majority of patients with these complications had full resolution by the sixth postoperative month. Tube dislodgement was a complication, occurring 16 times in 14 of the patients (10%) and resulting in 16 emergency department (ED) visits. Diagnoses were predictive of complications, and age and gender were not. Granulation tissue, vomiting, infection, leakage and tube dislodgement are complications after gastrostomy placement in children. The age of the child, was not predictive of complications but children with congenital cardiac malformation and malignant diseases had more frequent postoperative complications.
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