Several publications have attempted to clarify the differences between percutaneous endoscopic gastrostomy (PEG) and laparoscopic gastrostomy (LAG) tube placement in the pediatric population. However, a definitive conclusion has yet to be reached. To help answer this question, we examined the length of hospital stay and time to goal feeds in a longitudinal pediatric cohort. As surgeons performing these interventions, usually in already nutritional deprived infants, physicians may need to consider the time to goal feeds and hospital length of stay between different approaches in addition to their known complications. We performed a retrospective chart review of all pediatric patients 0-17 years old who required gastrostomy tube insertion from 1998 - 2016 at a single institution. Data from all forms of gastrostomy tube placement were extracted and then filtered to include only PEG and LAG tubes. 53 LAG and 174 PEG cases were analyzed. The mean gestational age of the two groups was 1.31 ± 2.61 and 3.10 ± 4.72 years (p = 0.0007) and weight at the time of procedure was 7.35 ± 6.56 kg and 13.00 ± 16.00 kg (p = 0.0002), respectively. The mean time to initiation to full feeds were 61.6 ± 44.8 hours and 58.4 ± 142 hours, respectively. Through t-test statistical analysis, the difference in time to goal feeds was not significant (p = 0.8066). In terms of hospital stay length, the groups averaged 9.67 ± 24 days and 7 ± 12.1 days; again, this was not statistically significant between the two cohorts (p = 0.4713). While there is no significant difference between LAG tubes and PEG placement in regards to initiation to full feeds and length of hospital post-operatively, the patients in LAG cases were significantly younger and smaller in comparison. These clinical characteristics make it difficult to compare the two techniques but do not reveal a favorable outcome in either approach.
Differences between LAG and PEG in terms of time required to achieve full feeds in hours.
Differences between length of hospital stay between LAG and PEG group in days.