COMPARISON OF LAPAROSCOPIC VERSUS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY FOR LONG TERM ASSISTED ENTERAL FEED IN TRAUMA PATIENTS - A RANDOMIZED PILOT STUDY narendra3483@gmail.com

 

COMPARISON OF LAPAROSCOPIC VERSUS PERCUTANEOUS ENDOSCOPIC GASTROSTOMY FOR LONG TERM ASSISTED ENTERAL FEED IN TRAUMA PATIENTS - A RANDOMIZED PILOT STUDY

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India

Oral or Poster

Enteral-feed in polytrauma patient is crucial but often overlooked. Many such patients are unable to accept oral feeds for extended periods due to head or maxillofacial injuries. Percutaneous Endoscopic Gastrostomy (PEG) is the current standard of care for providing long term assisted enteral feeding. However it is associated with procedure or tube related complications. Laparoscopic gastrostomy (LG) provides an alternative to PEG placement with lesser complications among pediatric patients. However its role among adult trauma victims is still unclear and paving the way for this feasibility trial.

Patients with severe head or maxillofacial injuries requiring long-term assisted enteral feeding, randomised into two cohorts. Patients on antibiotic therapy or history of abdominal surgery excluded. Post-procedure, both groups were monitored for signs of procedure and/or tube related complications. Procedural costs were calculated based on required consumables and investigations prompted by any complications.

30 patients with mean age of 38±14.52 years recruited. Mean procedural duration was 27.13±7.68 & 78.6 ±11.72 minutes for PEG and LG respectively. Enteral feed initiated on day 1 in 8(53%) & 03(20%), day 2 in 5(33%) & 9(60%) patients after PEG & LG placement. 01(6.67%) and 07(47%) patient developed gastrostomy site infection following LG & PEG. Peri-tubal leakage and dislodgement was noted in 05 and 04 patient following PEG, in 01 and 02 patient after LG. Procedural cost was $110±30 & 281±30 for PEG & LG.

LG, though associated with higher procedural costs and longer operative times, demonstrates a lower incidence of surgical site infections and tube-related complications.