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Eric Monnet - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of gastric motility in nine dogs before and after prophylactic laparoscopic Gastropexy: a pilot study
Australian veterinary journal, 2019Co-Authors: Ka Coleman, Pedro Boscan, L.e. Ferguson, David C. Twedt, Eric MonnetAbstract:The purpose of this study was to evaluate the effect of a prophylactic laparoscopic Gastropexy on gastric motility in healthy large-breed dogs. This was a prospective pilot study with nine healthy client-owned dogs. Each dog was its own control. Gastric motility was evaluated before and after laparoscopic Gastropexy. Dogs were fed a standard diet three weeks before and after surgery. Gastric motility was measured before and 3 weeks after surgery. A wireless motility capsule (WMC) was used to measure gastric pH, intragastric pressure, temperature, frequency of contractions, motility index (MI) and transit time. Non-parametric statistical analysis was used to compare the paired data. Clients were contacted for follow-up information 2 years postoperatively. Median frequency of gastric contractions was 1.3 (range, 0.6-1.9 contractions/min) before Gastropexy and 1.0 (range, 0.3-2.6 contractions/min) after Gastropexy (P = 0.820). Median MI was 49.2 (range, 23.7-96.6) before Gastropexy and 28.1 (range, 12.2-148.9) after Gastropexy (P = 0.652). Median gastric emptying time was 1140 (range, 486-1230 min) before Gastropexy and 1110 (range, 306-2610 min) after Gastropexy (P = 0.570). During the hour before the WMC passed through the pylorus, median MI was 72.2 (range, 48.2-549.3) before Gastropexy and 52.9 (range, 15.20-322.8) after Gastropexy (P = 0.734), and frequency of contractions was 1.1 (range, 0.9-4.1 contractions/min) before Gastropexy and 1.2 (range, 0.5-3.0 contractions/min) after Gastropexy (P = 0.652). Motility in the stomach did not change in healthy dogs after prophylactic laparoscopic Gastropexy. We conclude that preventive laparoscopic Gastropexy does not induce gastroparesis. © 2019 Australian Veterinary Association.
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comparison of laparoscopic Gastropexy performed via intracorporeal suturing with knotless unidirectional barbed suture using a needle driver versus a roticulated endoscopic suturing device 30 cases
Veterinary Surgery, 2017Co-Authors: Kristin A. Coleman, Eric MonnetAbstract:Objective To compare two suturing techniques for prophylactic laparoscopic Gastropexy in healthy dogs. Study design Retrospective case series. Animals Thirty healthy client-owned dogs from breeds predisposed to gastric dilation volvulus. Methods Medical records of dogs presented for prophylactic laparoscopic Gastropexy performed with knotless unidirectional barbed suture were reviewed. Dogs were grouped based on the device used for suturing, consisting of an endoscopic needle driver (END) vs an endoscopic suturing device (ESD). Signalment, weight, surgery time, number of suture bites per side of Gastropexy, and intraoperative complications were compared between groups. Results The END group consisted of 10 dogs, with a median age of 1.09 years (range 0.5-2.67), weight of 41.5 kg (range 25-66), surgical time of 49.5 minutes (range 35-77), and a median of 5 suture bites per side (range 4-6). The ESD group included 20 dogs, with a median age of 1.75 years (range 0.6-8.75, P = .0944), weight was 37.5 kg (range 20-62, P = .5823), surgical time of 55 minutes (range 30-76, P = .808), and a median of 6 suture bites for the first side (range 4-7, P = .072) and 7 for the second side (range 4-8, P = .003). No major complications and no conversion to open celiotomy occured in either group. Minor complications occurred in 3 dogs in the ESD group, all related to device dysfunction and suture breakage. Conclusion Laparoscopic Gastropexy may be performed effectively with either of these suturing techniques.
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laparoscopic Gastropexy using knotless unidirectional suture and an articulated endoscopic suturing device seven cases
Veterinary Surgery, 2016Co-Authors: Kristin A. Coleman, Sean Adams, Daniel D. Smeak, Eric MonnetAbstract:Objective To describe a technique for laparoscopic incisional Gastropexy using an articulated endoscopic suturing device with knotless unidirectional barbed suture in healthy large breed dogs. Study Design Prospective case series. Animals Healthy client-owned dogs presented for prophylactic Gastropexy and weighing >20 kg (n=7). Methods Incisional Gastropexy was performed using a single port access system with an articulated endoscopic suturing device. An additional 5 mm cannula was placed in the right caudal abdomen. A 2-0 knotless unidirectional barbed suture was used to complete the Gastropexy with 2 separate simple continuous suture lines. All dogs underwent a focal abdominal ultrasound to evaluate the Gastropexy site 3–12 months postoperatively. Results Median weight of the dogs was 33.5 kg (range, 20–51 kg) and the median age was 2 years (range, 0.6–8.5 years). Median surgical time was 60 minutes (range, 39–88). The articulated suturing device malfunctioned twice. On abdominal ultrasound between 3 and 12 months, all Gastropexy sites were intact. No motion was detected between the stomach and body wall during distal antral contractions or respiratory motion and a focal thickening of the gastric wall was present in dog. No complications were reported in the postoperative periods as of the 2 week suture removal visit or as of the time of their ultrasound appointment. Conclusion This technique using an endoscopic articulated suturing device with a knotless unidirectional barbed suture provides a feasible technique to perform laparoscopic Gastropexy.
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Laparoscopic Gastropexy Using Knotless Unidirectional Suture and an Articulated Endoscopic Suturing Device: Seven Cases
Veterinary surgery : VS, 2016Co-Authors: Kristin A. Coleman, Sean Adams, Daniel D. Smeak, Eric MonnetAbstract:To describe a technique for laparoscopic incisional Gastropexy using an articulated endoscopic suturing device with knotless unidirectional barbed suture in healthy large breed dogs. Prospective case series. Healthy client-owned dogs presented for prophylactic Gastropexy and weighing >20 kg (n=7). Incisional Gastropexy was performed using a single port access system with an articulated endoscopic suturing device. An additional 5 mm cannula was placed in the right caudal abdomen. A 2-0 knotless unidirectional barbed suture was used to complete the Gastropexy with 2 separate simple continuous suture lines. All dogs underwent a focal abdominal ultrasound to evaluate the Gastropexy site 3-12 months postoperatively. Median weight of the dogs was 33.5 kg (range, 20-51 kg) and the median age was 2 years (range, 0.6-8.5 years). Median surgical time was 60 minutes (range, 39-88). The articulated suturing device malfunctioned twice. On abdominal ultrasound between 3 and 12 months, all Gastropexy sites were intact. No motion was detected between the stomach and body wall during distal antral contractions or respiratory motion and a focal thickening of the gastric wall was present in dog. No complications were reported in the postoperative periods as of the 2 week suture removal visit or as of the time of their ultrasound appointment. This technique using an endoscopic articulated suturing device with a knotless unidirectional barbed suture provides a feasible technique to perform laparoscopic Gastropexy. © Copyright 2016 by The American College of Veterinary Surgeons.
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biomechanical analysis of laparoscopic incisional Gastropexy with intracorporeal suturing using knotless polyglyconate
Veterinary Surgery, 2015Co-Authors: Darren J Imhoff, Andrea Cohen, Eric MonnetAbstract:Objective To evaluate load to failure of laparoscopic incisional Gastropexy performed with intracorporeal suturing using knotless polyglyconate (KP). Study Design Cadaveric study. Animals Canine cadavers (n = 12). Methods Laparoscopic incisional Gastropexy using 2 strands of KP was performed in 6 canine cadavers and by an open approach in 6 cadavers. Length of the Gastropexy, number of suture bites on each side of the Gastropexy, and number of inadvertent full thickness gastric suture bites were recorded. Load to failure was measured. Results There was no significant difference in mean (±SD) Gastropexy load to failure for the open (46.3 ± 19.6 N) and laparoscopic (69.0 ± 26.0 N) approaches (P = .123). No significant differences between laparoscopic and open approaches were detected for mean stomach (3.1 ± 0.1 cm; 3.0 ± 0.2 cm; P = .353) or abdominal wall (3.1 ± 0.2 cm; 3.0 ± 0.2 cm; P = .553) incision lengths. There was no significant difference between groups for number of suture bites medially (P = .448) or laterally (P = .363). There were 3 instances of a single gastric intraluminal suture for the laparoscopic group and none for the open approach (P = .023). Conclusion Incisional Gastropexy performed with laparoscopic intracorporeal suturing and KP has a load to failure that is comparable with an open method. Load to failure was similar to reported values for open incisional Gastropexy with knotless glycomer 631.
Philipp D Mayhew - One of the best experts on this subject based on the ideXlab platform.
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total laparoscopic Gastropexy using 1 simple continuous barbed suture line in 63 dogs
Veterinary Surgery, 2017Co-Authors: J. Takács, Alexander W Foxalvarez, Michelle A. Giuffrida, Ameet Singh, Ana V. Caceres, Brad J Case, Philipp D Mayhew, Jeffrey J RungeAbstract:Objective To describe the use and outcome of a single, simple continuous, barbed suture line for prophylactic, total laparoscopic Gastropexy in dogs. Study Design Multi-center, retrospective case series. Animals Sixty-three client-owned dogs. Methods Medical records of dogs undergoing total laparoscopic Gastropexy using a barbed suture at 4 academic veterinary hospitals from 2011-2015 were reviewed. Data collected included signalment, procedure time, procedure-associated complications, short-term complications, and long-term outcome. All procedures were performed under general anesthesia in dorsal to dorsal-left oblique recumbency. Laparoscopic ports were placed on ventral midline in 1 of 3 port configurations, and 5 mm laparoscopic needle drivers were used for intracorporeal sutured Gastropexy with unidirectional barbed suture. The Gastropexy was positioned just caudal to the 13th rib, 2-4 cm lateral to the rectus abdominis muscle. Results Sixty-three dogs underwent total laparoscopic Gastropexy with a single, simple continuous, barbed suture line. Median Gastropexy surgery time was 70 minutes (interquartile range [IQR] 60-90 minutes). One dog sustained splenic laceration from Veress needle penetration during initial abdominal insufflation. Short term (>24 hours to 6 months postoperative) complications included incisional seroma formation (n = 2) and suture reaction (n = 1). Long term (>6 months postoperative) complications included intermittent regurgitation and chronic diarrhea in 1 dog. Fifteen dogs had postoperative ultrasound and all had intact Gastropexy sites. Conclusion Total laparoscopic barbed Gastropexy using a single, simple continuous, barbed suture line in dogs is safe and results in an intact Gastropexy long term.
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Total laparoscopic Gastropexy using 1 simple continuous barbed suture line in 63 dogs.
Veterinary surgery : VS, 2016Co-Authors: Joel D. Takacs, Michelle A. Giuffrida, Ameet Singh, Ana V. Caceres, Philipp D Mayhew, J. Brad Case, W. Alexander Fox-alvarez, Jeffrey J RungeAbstract:To describe the use and outcome of a single, simple continuous, barbed suture line for prophylactic, total laparoscopic Gastropexy in dogs. Multi-center, retrospective case series. Sixty-three client-owned dogs. Medical records of dogs undergoing total laparoscopic Gastropexy using a barbed suture at 4 academic veterinary hospitals from 2011-2015 were reviewed. Data collected included signalment, procedure time, procedure-associated complications, short-term complications, and long-term outcome. All procedures were performed under general anesthesia in dorsal to dorsal-left oblique recumbency. Laparoscopic ports were placed on ventral midline in 1 of 3 port configurations, and 5 mm laparoscopic needle drivers were used for intracorporeal sutured Gastropexy with unidirectional barbed suture. The Gastropexy was positioned just caudal to the 13th rib, 2-4 cm lateral to the rectus abdominis muscle. Sixty-three dogs underwent total laparoscopic Gastropexy with a single, simple continuous, barbed suture line. Median Gastropexy surgery time was 70 minutes (interquartile range [IQR] 60-90 minutes). One dog sustained splenic laceration from Veress needle penetration during initial abdominal insufflation. Short term (>24 hours to 6 months postoperative) complications included incisional seroma formation (n = 2) and suture reaction (n = 1). Long term (>6 months postoperative) complications included intermittent regurgitation and chronic diarrhea in 1 dog. Fifteen dogs had postoperative ultrasound and all had intact Gastropexy sites. Total laparoscopic barbed Gastropexy using a single, simple continuous, barbed suture line in dogs is safe and results in an intact Gastropexy long term. © 2016 The American College of Veterinary Surgeons.
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description and biomechanical comparison of a percutaneous radiologic Gastropexy technique in a canine cadaver model
Veterinary Surgery, 2016Co-Authors: William T. N. Culp, Philipp D Mayhew, Ingrid M. Balsa, Eric G. Johnson, Craig B. Glaiberman, Millie Grimes, Carrie A. Palm, Sun Young Kim, Tanya C Garcia, Philip H KassAbstract:Objective To describe a novel percutaneous radiologic Gastropexy (PRG) technique in a canine model and to biomechanically compare this technique to open incisional Gastropexy (OIG) and laparoscopic-assisted incisional Gastropexy (LAG). Study Design Randomized ex vivo biomechanical study. Animals: Canine cadavers. Methods Fifteen cadavers were randomized to 1 of 3 surgical interventions: OIG, LAG, and PRG. For the PRG procedure, the stomach was distended with air, and a preloaded T-fastener device was utilized to attach the stomach to the body wall with fluoroscopic-guidance. The procedural times of the 3 techniques were recorded. After completion of the procedure, the stomach and body wall overlying the stomach wall were harvested and the maximum tensile strength of the gastropexies was determined. Results The maximal tensile strength was not significantly different between groups. The total procedural time for the PRG procedure (5 minutes) was significantly shorter than both OIG (28 minutes) and LAG (20 minutes) procedures. Conclusion The PRG technique described in this study demonstrated a similar maximal tensile strength to commonly employed Gastropexy techniques (OIG and LAG) in an acute canine model. Additionally, the PRG procedure was significantly faster to perform. The clinical relevance of this technique will be determined by further study to assess the applicability and efficacy of this procedure in clinical patients by determining the likelihood of adhesion development and the ability of the adhesion to prevent gastric volvulus.
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Description and Biomechanical Comparison of a Percutaneous Radiologic Gastropexy Technique in a Canine Cadaver Model
Veterinary surgery : VS, 2016Co-Authors: William T. N. Culp, Philipp D Mayhew, Ingrid M. Balsa, Eric G. Johnson, Craig B. Glaiberman, Millie Grimes, Carrie A. Palm, Sun Young Kim, Tanya C Garcia, Philip H KassAbstract:To describe a novel percutaneous radiologic Gastropexy (PRG) technique in a canine model and to biomechanically compare this technique to open incisional Gastropexy (OIG) and laparoscopic-assisted incisional Gastropexy (LAG). Randomized ex vivo biomechanical study. Canine cadavers. Fifteen cadavers were randomized to 1 of 3 surgical interventions: OIG, LAG, and PRG. For the PRG procedure, the stomach was distended with air, and a preloaded T-fastener device was utilized to attach the stomach to the body wall with fluoroscopic-guidance. The procedural times of the 3 techniques were recorded. After completion of the procedure, the stomach and body wall overlying the stomach wall were harvested and the maximum tensile strength of the gastropexies was determined. The maximal tensile strength was not significantly different between groups. The total procedural time for the PRG procedure (5 minutes) was significantly shorter than both OIG (28 minutes) and LAG (20 minutes) procedures. The PRG technique described in this study demonstrated a similar maximal tensile strength to commonly employed Gastropexy techniques (OIG and LAG) in an acute canine model. Additionally, the PRG procedure was significantly faster to perform. The clinical relevance of this technique will be determined by further study to assess the applicability and efficacy of this procedure in clinical patients by determining the likelihood of adhesion development and the ability of the adhesion to prevent gastric volvulus. © Copyright 2016 by The American College of Veterinary Surgeons.
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Efficacy of Two Radiologic-Assisted Prophylactic Gastropexy Techniques.
Veterinary surgery : VS, 2016Co-Authors: Ingrid M. Balsa, Philipp D Mayhew, William T. N. Culp, Eric G. Johnson, Craig B. Glaiberman, Millie Grimes, Carrie A. PalmAbstract:Objective To describe the technique and clinical outcome of prophylactic percutaneous radiologic-assisted Gastropexy (PRG) and radiologic-assisted incisional Gastropexy (RIG) in client-owned dogs. Study Design Prospective, nonrandomized clinical trial. Animals Fourteen client-owned, large, and giant breed dogs. Methods Four dogs underwent PRG with fluoroscopic guidance to place 2 T-fasteners into the pyloric antrum and secure it to the right body wall. Ten dogs underwent RIG, which was a modification of PRG. For RIG, the T-fasteners were first used to approximate the pyloric antrum and body wall, then a full thickness incision through the body wall was made and the pyloric antrum was sutured to the internal abdominal wall. The duration and complications of each procedure were recorded. The Gastropexy was assessed by abdominal ultrasound at day 1, week 2, and week 8 postoperative and by barium gastrogram at week 8 postoperative. Results No dogs undergoing PRG had a Gastropexy present at week 2. All dogs undergoing RIG had ultrasonographic evidence of Gastropexy at day 1, week 2, and week 8 postoperative. Gastrograms in 9/9 dogs were consistent with an intact Gastropexy, appropriate gastric positioning and appropriate gastric emptying began. No major complications were noted. Conclusion The PRG was unsatisfactory and did not result in a permanent Gastropexy. The RIG was safe and created a Gastropexy that remained intact at 8 weeks postoperative. The RIG should be considered as a minimally invasive option for prophylactic Gastropexy in dogs of at-risk breeds.
Jeffrey J Runge - One of the best experts on this subject based on the ideXlab platform.
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total laparoscopic Gastropexy using 1 simple continuous barbed suture line in 63 dogs
Veterinary Surgery, 2017Co-Authors: J. Takács, Alexander W Foxalvarez, Michelle A. Giuffrida, Ameet Singh, Ana V. Caceres, Brad J Case, Philipp D Mayhew, Jeffrey J RungeAbstract:Objective To describe the use and outcome of a single, simple continuous, barbed suture line for prophylactic, total laparoscopic Gastropexy in dogs. Study Design Multi-center, retrospective case series. Animals Sixty-three client-owned dogs. Methods Medical records of dogs undergoing total laparoscopic Gastropexy using a barbed suture at 4 academic veterinary hospitals from 2011-2015 were reviewed. Data collected included signalment, procedure time, procedure-associated complications, short-term complications, and long-term outcome. All procedures were performed under general anesthesia in dorsal to dorsal-left oblique recumbency. Laparoscopic ports were placed on ventral midline in 1 of 3 port configurations, and 5 mm laparoscopic needle drivers were used for intracorporeal sutured Gastropexy with unidirectional barbed suture. The Gastropexy was positioned just caudal to the 13th rib, 2-4 cm lateral to the rectus abdominis muscle. Results Sixty-three dogs underwent total laparoscopic Gastropexy with a single, simple continuous, barbed suture line. Median Gastropexy surgery time was 70 minutes (interquartile range [IQR] 60-90 minutes). One dog sustained splenic laceration from Veress needle penetration during initial abdominal insufflation. Short term (>24 hours to 6 months postoperative) complications included incisional seroma formation (n = 2) and suture reaction (n = 1). Long term (>6 months postoperative) complications included intermittent regurgitation and chronic diarrhea in 1 dog. Fifteen dogs had postoperative ultrasound and all had intact Gastropexy sites. Conclusion Total laparoscopic barbed Gastropexy using a single, simple continuous, barbed suture line in dogs is safe and results in an intact Gastropexy long term.
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Total laparoscopic Gastropexy using 1 simple continuous barbed suture line in 63 dogs.
Veterinary surgery : VS, 2016Co-Authors: Joel D. Takacs, Michelle A. Giuffrida, Ameet Singh, Ana V. Caceres, Philipp D Mayhew, J. Brad Case, W. Alexander Fox-alvarez, Jeffrey J RungeAbstract:To describe the use and outcome of a single, simple continuous, barbed suture line for prophylactic, total laparoscopic Gastropexy in dogs. Multi-center, retrospective case series. Sixty-three client-owned dogs. Medical records of dogs undergoing total laparoscopic Gastropexy using a barbed suture at 4 academic veterinary hospitals from 2011-2015 were reviewed. Data collected included signalment, procedure time, procedure-associated complications, short-term complications, and long-term outcome. All procedures were performed under general anesthesia in dorsal to dorsal-left oblique recumbency. Laparoscopic ports were placed on ventral midline in 1 of 3 port configurations, and 5 mm laparoscopic needle drivers were used for intracorporeal sutured Gastropexy with unidirectional barbed suture. The Gastropexy was positioned just caudal to the 13th rib, 2-4 cm lateral to the rectus abdominis muscle. Sixty-three dogs underwent total laparoscopic Gastropexy with a single, simple continuous, barbed suture line. Median Gastropexy surgery time was 70 minutes (interquartile range [IQR] 60-90 minutes). One dog sustained splenic laceration from Veress needle penetration during initial abdominal insufflation. Short term (>24 hours to 6 months postoperative) complications included incisional seroma formation (n = 2) and suture reaction (n = 1). Long term (>6 months postoperative) complications included intermittent regurgitation and chronic diarrhea in 1 dog. Fifteen dogs had postoperative ultrasound and all had intact Gastropexy sites. Total laparoscopic barbed Gastropexy using a single, simple continuous, barbed suture line in dogs is safe and results in an intact Gastropexy long term. © 2016 The American College of Veterinary Surgeons.
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Laparoscopic-assisted and laparoscopic prophylactic Gastropexy: indications and techniques.
Compendium (Yardley PA), 2009Co-Authors: Jeffrey J Runge, Philipp D Mayhew, Clarence A. RawlingsAbstract:Gastric dilatation–volvulus (GDV) is a syndrome characterized by rapid accumulation of gas or food in the stomach, increased intragastric pressure and wall tension, and rotation of the stomach about its long axis. Gastric distention unleashes a series of potentially lethal pathophysiologic events, the most important of which are compression of the portal and caudal vena caval venous blood flow, gastric necrosis, tissue acidosis, cardiac arrhythmia, disseminated intravascular coagulation, and hypotensive and cardiogenic shock. For dogs that develop GDV, surgical correction is strongly recommended. Among those dogs, mortality remains high (15% to 33%), even with aggressive resuscitative management. A Gastropexy is the creation of a permanent adhesion between the gastric antrum and the adjacent right body wall. Failure to perform a Gastropexy at the time of surgery for GDV correction results in a >50% recurrence rate, whereas performing a prophylactic Gastropexy during corrective surgery for GDV decreases the recurrence rate by 4% to 10%. As a result, Gastropexy is now considered the standard of care. Several open surgical Gastropexy techniques have been described: tube, circumcostal, belt loop, muscular flap, gastrocolopexy, and incisional. Because of the high mortality rate associated with the development of GDV, these procedures may be used prophylactically in dogs that have not had GDV but are considered to be at high risk. Studies have indicated that a prophylactic Gastropexy can result in a twofold to 30-fold reduction in lifetime mortality associated with GDV for rottweilers and Great Danes, respectively. Recent advances in veterinary medicine have included a move toward more miniRisk Factors for Gastric Dilatation–Volvulus Page 60
Okan Akhan - One of the best experts on this subject based on the ideXlab platform.
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long term results of percutaneous radiologic gastrostomy and gastrojejunostomy in children with emphasis on technique single or double Gastropexy
American Journal of Roentgenology, 2010Co-Authors: Devrim Akinci, Turkmen Ciftci, Diana Kaya, Mustafa Ozmen, Okan AkhanAbstract:OBJECTIVE. The purpose of this article is to evaluate the safety and efficacy of radiologic gastrostomy and gastrojejunostomy in children, with an emphasis on the comparison of single and double Gastropexy.MATERIALS AND METHODS. Between January 2000 and May 2009, a total of 91 percutaneous tubes (77 gastrostomies and 14 gastrojejunostomies) were placed in 90 patients. Patients' ages ranged from 4 months to 16.5 years. Gastropexy was performed in all cases. The first 50 children underwent double Gastropexy, and 40 children underwent single Gastropexy. In single Gastropexy, two different punctures were performed each for the anchor and the tube. Differences in the incidence of major and minor complications and tube maintenance problems between the single- and double-Gastropexy groups were retrospectively analyzed by use of Fisher's exact test.RESULTS. The technical success rate was 100%. No procedure-related mortality or morbidity was detected. The overall major and minor complication rates were 4.4% and 16...
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Long-Term Results of Percutaneous Radiologic Gastrostomy and Gastrojejunostomy in Children With Emphasis on Technique: Single or Double Gastropexy?
AJR. American journal of roentgenology, 2010Co-Authors: Devrim Akinci, Turkmen Ciftci, Diana Kaya, Mustafa Ozmen, Okan AkhanAbstract:The purpose of this article is to evaluate the safety and efficacy of radiologic gastrostomy and gastrojejunostomy in children, with an emphasis on the comparison of single and double Gastropexy. Between January 2000 and May 2009, a total of 91 percutaneous tubes (77 gastrostomies and 14 gastrojejunostomies) were placed in 90 patients. Patients' ages ranged from 4 months to 16.5 years. Gastropexy was performed in all cases. The first 50 children underwent double Gastropexy, and 40 children underwent single Gastropexy. In single Gastropexy, two different punctures were performed each for the anchor and the tube. Differences in the incidence of major and minor complications and tube maintenance problems between the single- and double-Gastropexy groups were retrospectively analyzed by use of Fisher's exact test. The technical success rate was 100%. No procedure-related mortality or morbidity was detected. The overall major and minor complication rates were 4.4% and 16.7%, respectively. The mean follow-up period was 463 days. Twenty-nine tube maintenance problems were detected in 17 patients. There were four major complications (two cases of aspiration pneumonia and two site infections that required hospitalization). Minor complications occurred in 15 patients (nine localized site infections, two cases of gastroesophageal reflux, and four tube maintenance problems requiring secondary intervention). In total, 26 and 22 complications and tube maintenance problems occurred in the single- and double-Gastropexy groups, respectively. No statistically significant difference was detected between the two groups in terms of complications (p > 0.005). Radiologic gastrostomy and gastrojejunostomy are safe and effective methods for long-term nutritional support in children. Single Gastropexy should be performed with two different punctures for each retention suture and the tube.
Peter Malfertheiner - One of the best experts on this subject based on the ideXlab platform.
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Long-Term Results with a New Introducer Method with Gastropexy for Percutaneous Endoscopic Gastrostomy
The American journal of gastroenterology, 2006Co-Authors: Arno J. Dormann, Bernd Wejda, Stefan Kahl, Hans Huchzermeyer, Matthias P. Ebert, Peter MalfertheinerAbstract:Long-Term Results with a New Introducer Method with Gastropexy for Percutaneous Endoscopic Gastrostomy
