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 [4–6]. 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, 7–9]. 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
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