Evaluation of minimally invasive percutaneous gastrostomy with Nissen fundoplication versus open surgery in children with infantile cerebral palsy Original Research

Abstract

Introduction: Children with infantile cerebral palsy (ICP) have severe nutritional disorders due to gastrointestinal symptoms such as gastroesophageal reflux (GER). The objective of the present study was to compare minimally invasive percutaneous gastrostomy techniques with Nissen Funduplicature (MI-NF) versus open surgery (OS-NF) for the treatment of gastroesophageal reflux and swallowing disorders in children with child brain paralysis.

Methodology: This observational study with nonprobabilistic sampling included children with ICP swallowing disorders and GER at the Dr. Roberto Gilbert Elizalde Children's Hospital in Guayaquil-Ecuador from 2017 to 2022. Age, type of surgery, complications, feeding start time, symptoms, and comorbidities. A descriptive analysis is performed. A second analysis compared patients treated with MI-NF + percutaneous gastrostomy versus OS-NF + Stamm-type gastrostomy.

Results: Sixty-two patients were included: 40 men (64.5%), 39 patients <3 years old (62.9%); 27 patients with severe malnutrition (61.4%); 13 patients (29.5%) who were admitted for an episode of pneumonia; 52 patients with OS-NF; and 10 with MI-NF. The start of feeding at 48 hours in the MI-NF group was 8 cases (80%); in OS-NF, 3 cases (5.8%) P<0.0001. There were no differences in age or complications between the groups.

Conclusion: With the technique of percutaneous gastrostomy with MI-NF, there was a minimum time when the patients started feeding through the gastrostomy tube.