%0 Journal Article
%T Pre- and Postoperative Vomiting in Children Undergoing Video-Assisted Gastrostomy Tube Placement
%A Torbj£¿rn Backman
%A Hel¨¦n Sj£¿vie
%A Malin Mellberg
%A Anna B£¿rjesson
%A Magnus Anderberg
%A Carl-Magnus Kullendorff
%A Einar Arnbj£¿rnsson
%J Surgery Research and Practice
%D 2014
%R 10.1155/2014/871325
%X 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. 1. Introduction Gastrostomy is advocated for children with long-term nutritional feeding problems exceeding 3 months, independent of the underlying diagnosis. The percutaneous endoscopic gastrostomy (PEG) technique has been the most widely used method to achieve enteral access since its introduction in 1980 [1]. Due to an association between the PEG procedure and serious complications [2, 3] such as gastroenteric fistulas, we have, at our Department of Paediatric Surgery, chosen to use and further develop the Video-Assisted Gastrostomy (VAG) technique since 1994 [4¨C6]. The advantages of the VAG technique over PEG are better visual control intra-abdominally, the secure positioning of the stoma to the gastric wall, and the gastroscopic control of the gastrostomy button placement in the ventricle cavity [3, 4, 7¨C9]. Many centres now use the laparoscopic technique because it is considered to be a safer method [10, 11]. Vomiting is a natural physiological process in children and is associated with gastroesophageal reflux (GER) and sometimes with gastroesophageal reflux disease (GERD) [12]. Whether gastrostomies lead to exacerbation of GERD has been debated, but guidelines and consensus nowadays
%U http://www.hindawi.com/journals/srp/2014/871325/