title: [Comparison of two types of surgical gastrostomies, open and laparoscopic in home enteral nutrition].
abstract: OBJECTIVE
  Exposing the complications of surgical gastrostomies used as way of home enteral nutritional support (HEN) and detecting the differences between the two techniques used in our environment: Open Surgery vs Laparoscopic Surgery.
  
  
  METHODS
  Retrospective descriptive observational study of the surgical gastrostomies performed between 1994 and 2009 followed up by our unit. Have been analyzed the complications detected in our practice during the follow-up of patients with HEN performed via open laparotomy vs. laparoscopic tecniques, assessing: leaks of gastric fluid to the exterior, abdominal wall irritation, presence of exudate, presence of exudate with positive culture that required antibiotical treatment, burning or loss of substance of the periostomic zone, breach of balloon, decubitus ulcer caused by the tube and formation of granuloma.
  
  
  RESULTS
  Between 1994 and 2009, 57 surgical gastrostomies were performed: 47 using the conventional laparotomic (open) tecnique and 10 laparoscopies. The average age of the patients was 57.51 ± 17.29 years old. The most common cause for the performance of surgical gastrostomy was esophageal cancer (38.6%) followed by neurologic alterations (26.3%) and head and neck tumors (26.3%). 97.9% of the patients who underwent to surgical gastrostomy presented at least one complication, meaning that only 2.1% were free of complications; meanwhile, 50% of the patients were laparoscopic gastrostomy was performed had none of these complications. The most common complications were the presence of leaks of gastric fluid and abdominal wall irritation that appeared on 89.4% and 83% respectively of the laparotomic gastrostomies versus the presence of only 30% of both complications in laparoscopic gastrostomies being the difference statistically significant (p < 0.01).
  
  
  CONCLUSIONS
  After the introduction of the laparoscopic technique in the performance of surgical gastrostomies has been observed a decrease of the complications occured during the home enteral nutritional support related to surgical gastrostomies.
authors.affiliation: Unidad de Nutrición Clínica, Unidad de Gestión Clínica de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla, Sevilla, España. mariatous2@gmail.com
authors.forename: M C
authors.initials: MC
authors.lastname: Tous Romero
authors.forename: I
authors.initials: I
authors.lastname: Alarcón del Agua
authors.forename: J
authors.initials: J
authors.lastname: Parejo Campos
authors.forename: R
authors.initials: R
authors.lastname: Oliva Rodríguez
authors.forename: P
authors.initials: P
authors.lastname: Serrano Aguayo
authors.forename: J M
authors.initials: JM
authors.lastname: Hisnard Cadet Dussort
authors.forename: J L
authors.initials: JL
authors.lastname: Pereira Cunill
authors.forename: S
authors.initials: S
authors.lastname: Morales-Conde
authors.forename: P P
authors.initials: PP
authors.lastname: García-Luna
mesh_terms: D000368:Aged; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016331:Parenteral Nutrition, Home / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013270:Stomach / Q000502:physiology