gastrostomy

The Stamm gastrostomy is an open technique,{{cite journal |author1=P C Shellito |author2=R A Malt |year=1985 |title=Tube gastrostomy. Techniques and complications |journal=Annals of Surgery |volume=201 |issue=2 |pages=180–185 |doi= 10.1097/00000658-198502000-00008|pmc=1250638 |pmid= 3918515}} requiring an upper midline laparotomy and gastrotomy, with the catheter brought out in the left hypochondrium. It was first devised in 1894 by the American Gastric Surgeon, Martin Stamm (1847–1918), who was educated greatly in surgery when he visited Germany.:de:Martin Stamm{{Circular reference|date=May 2017}}

Over the last three decades less invasive approaches such as percutaneous endoscopic gastrostomy (PEG) and laparoscopic assisted Stamm gastrostomy{{Cite journal |last1=Kaya |first1=Mete |last2=Sancar |first2=Serpil |last3=Ozcakir |first3=Esra |date=January 2018 |title=A New Method for Laparoscopic Stamm Gastrostomy |url=https://pubmed.ncbi.nlm.nih.gov/29227195/ |journal=Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A |volume=28 |issue=1 |pages=111–115 |doi=10.1089/lap.2017.0447 |issn=1557-9034 |pmid=29227195}} have become increasingly popular.{{Cite journal |last1=Rothenberg |first1=S. S. |last2=Bealer |first2=J. F. |last3=Chang |first3=J. H. |date=October 1999 |title=Primary laparoscopic placement of gastrostomy buttons for feeding tubes. A safer and simpler technique |url=https://pubmed.ncbi.nlm.nih.gov/10526034/ |journal=Surgical Endoscopy |volume=13 |issue=10 |pages=995–997 |doi=10.1007/s004649901154 |issn=0930-2794 |pmid=10526034|s2cid=11945156 }}{{Cite journal |last=Georgeson |first=K. E. |date=1998-03-01 |title=Laparoscopic Fundoplication and Gastrostomy |url=http://journals.sagepub.com/doi/10.1177/155335069800500106 |journal=Surgical Innovation |language=en |volume=5 |issue=1 |pages=25–30 |doi=10.1177/155335069800500106 |pmid=9516557 |s2cid=1468213 |issn=1553-3506|url-access=subscription }}{{Cite journal |last1=Gauderer |first1=M. W. |last2=Ponsky |first2=J. L. |last3=Izant |first3=R. J. |date=December 1980 |title=Gastrostomy without laparotomy: a percutaneous endoscopic technique |url=https://pubmed.ncbi.nlm.nih.gov/6780678/ |journal=Journal of Pediatric Surgery |volume=15 |issue=6 |pages=872–875 |doi=10.1016/s0022-3468(80)80296-x |issn=0022-3468 |pmid=6780678}}

Conventional PEG involves inserting the primary feeding device through the mouth and extracting it through a small incision formed through the abdomen.{{Cite journal |last1=Gauderer |first1=M. W. |last2=Ponsky |first2=J. L. |last3=Izant |first3=R. J. |date=December 1980 |title=Gastrostomy without laparotomy: a percutaneous endoscopic technique |url=https://pubmed.ncbi.nlm.nih.gov/6780678/ |journal=Journal of Pediatric Surgery |volume=15 |issue=6 |pages=872–875 |doi=10.1016/s0022-3468(80)80296-x |issn=0022-3468 |pmid=6780678}}

Apparent benefits of PEG include shorter operative times and reduced financial cost.{{Cite journal |last1=Baker |first1=Laura |last2=Beres |first2=Alana L. |last3=Baird |first3=Robert |date=May 2015 |title=A systematic review and meta-analysis of gastrostomy insertion techniques in children |url=https://pubmed.ncbi.nlm.nih.gov/25783383/ |journal=Journal of Pediatric Surgery |volume=50 |issue=5 |pages=718–725 |doi=10.1016/j.jpedsurg.2015.02.021 |issn=1531-5037 |pmid=25783383|s2cid=21084418 }}{{Cite journal |last1=Fortunato |first1=John E. |last2=Troy |first2=April L. |last3=Cuffari |first3=Carmen |last4=Davis |first4=J. Erin |last5=Loza |first5=Matthew J. |last6=Oliva-Hemker |first6=Maria |last7=Schwarz |first7=Kathleen B. |date=April 2010 |title=Outcome after percutaneous endoscopic gastrostomy in children and young adults |journal=Journal of Pediatric Gastroenterology and Nutrition |volume=50 |issue=4 |pages=390–393 |doi=10.1097/MPG.0b013e3181aed6f1 |issn=1536-4801 |pmid=20179645|s2cid=25724743 |doi-access=free }}{{Cite journal |last1=Lee |first1=Hanmin |last2=Jones |first2=Angela |last3=Vasudevan |first3=Sanjeev |last4=Wulkan |first4=Mark L. |date=2002-03-01 |title=Evaluation of Laparoscopy-Assisted Percutaneous Gastrostomy Tube Placement in Children |url=https://www.liebertpub.com/doi/10.1089/10926410252832429 |journal=Pediatric Endosurgery & Innovative Techniques |volume=6 |issue=1 |pages=29–32 |doi=10.1089/10926410252832429 |issn=1092-6410|url-access=subscription }}

Severe complications for gastrostomy formation classify as Clavien-Dindo grade 3 and above, requiring surgical or radiological interventions with potential morbidity and mortality.{{Cite journal |last1=Sandberg |first1=Filip |last2=Viktorsdóttir |first2=Margrét Brands |last3=Salö |first3=Martin |last4=Stenström |first4=Pernilla |last5=Arnbjörnsson |first5=Einar |date=December 2018 |title=Comparison of major complications in children after laparoscopy-assisted gastrostomy and percutaneous endoscopic gastrostomy placement: a meta-analysis |journal=Pediatric Surgery International |volume=34 |issue=12 |pages=1321–1327 |doi=10.1007/s00383-018-4358-6 |issn=1437-9813 |pmc=6244983 |pmid=30291404}}{{Cite journal |last1=Dindo |first1=Daniel |last2=Demartines |first2=Nicolas |last3=Clavien |first3=Pierre-Alain |date=August 2004 |title=Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey |journal=Annals of Surgery |volume=240 |issue=2 |pages=205–213 |doi=10.1097/01.sla.0000133083.54934.ae |issn=0003-4932 |pmc=1360123 |pmid=15273542}} These complications may occur due to damage to surrounding structures intra-operatively, issues affecting the immature gastrostomy early post-operatively, or be secondary to device or site complications, including: adjacent bowel injury, gastrocolic fistulae, migration of gastrostomy to ribs, and failure for spontaneous closure when gastrostomy no longer needed (persistent gastrocutaneous fistula).{{Cite journal |last1=St-Louis |first1=Etienne |last2=Safa |first2=Nadia |last3=Guadagno |first3=Elena |last4=Baird |first4=Robert |date=May 2018 |title=Gastrocutaneous fistulae in children - A systematic review and meta-analysis of epidemiology and treatment options |url=https://pubmed.ncbi.nlm.nih.gov/29506816/ |journal=Journal of Pediatric Surgery |volume=53 |issue=5 |pages=946–958 |doi=10.1016/j.jpedsurg.2018.02.022 |issn=1531-5037 |pmid=29506816}}

• Enteral feeding
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• Stoma (medicine)

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Category:Enteral feeding

Category:Digestive system procedures