title: Outcome of laparoscopic versus open gastrostomy in children.
abstract: OBJECTIVE
  Laparoscopic gastrostomy (LAPG) has gained popularity in children. The aim of this study was to compare the outcome of LAPG versus open gastrostomy (OG) in children with focus on complications, operative times and postoperative length of stay.
  
  
  METHODS
  Retrospective study of children who had gastrostomies inserted at our tertiary Pediatric Surgery Center from 2000 until 2013. The indications for a gastrostomy were an anticipated need for enteral support for at least 6 months. Totally 243 children were included in the study, 83 with LAPG and 160 with OG.
  
  
  RESULTS
  We found a significant difference in postoperative length of stay, 3 days in the LAPG group versus 4 days in the OG group but no difference in a sub-group analysis from 2010 to 2013 when both techniques were used. There was no difference in median operative time or complications rates. Granuloma was the dominating complication in both groups.
  
  
  CONCLUSIONS
  These two feeding-access techniques are comparable regarding complications, operative times and postoperative length of stay. The choice of surgical method should be individualized based on the patient's characteristics and the experience of the surgeon. The favorable results with LAPG in adults are not necessarily transferable to children since there are physiological and anatomical differences.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden.
authors.forename: Gertrud
authors.initials: G
authors.lastname: Angsten
authors.affiliation: Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Danielson
authors.affiliation: Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden.
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: Kassa
authors.affiliation: Department of Women's and Children's Health, Uppsala University, SE-751 85, Uppsala, Sweden. helene.lilja@kbh.uu.se.|Department of Pediatric Surgery, University Children's Hospital, SE-751 85, Uppsala, Sweden. helene.lilja@kbh.uu.se.
authors.forename: Helene Engstrand
authors.initials: HE
authors.lastname: Lilja
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Children; Gastrostomy; Laparoscopic gastrostomy; Open gastrostomy