Presenter Status

Fellow

Abstract Type

Research

Primary Mentor

Tolulope A. Oyetunji, MD MPH

Start Date

5-5-2022 11:30 AM

End Date

5-5-2022 1:30 PM

Presentation Type

Poster Presentation

Description

Background: Same-day discharge (SDD) after outpatient laparoscopic gastrostomy tube (G-tube) placement has been our standard institutional practice since 2017, following written and video-based preoperative education regarding G-tube use, maintenance, and exchange at the time of consultation.

Objectives/Goal: We aim to evaluate caretaker satisfaction with our same day discharge protocol following laparoscopic gastrostomy tube placement.

Methods/Design: Following IRB approval, all patients planned for SDD after G-tube placement from FebruarySeptember 2021 at a tertiary care academic center were identified. Retrospective chart review was performed to identify demographic information, successful same-day discharge or reason for postoperative admission, time to first postoperative feed, length of stay (LOS), and complications requiring emergency department evaluation, readmission, or reoperation. Telephone follow-up at two weeks postoperatively was conducted to evaluate satisfaction with the SDD protocol.

Results: Thirty-four patients were eligible for SDD postoperatively. The median age was 1.0 years [IQR 0.65,5.04], and the median weight was 9.5 kg [7.3,14.1]. Fourteen (41%) patients were previously nasogastric fed. Twentyeight (82%) patients were successfully discharged same day with a median LOS of 7.7 hours [7.0,8.3], and 6 (18%) were admitted postoperatively for either further education or persistent emesis with a median LOS of 29.0 hours [26.8,31.3]. Median time to first feed was 2.3 hours [1.6,2.8]. Six patients (18%) returned to the ED within 30 days resulting in 2 (6%) readmissions for peri-stomal erythema and fever requiring oral antibiotics and a single tube dislodgement requiring operative replacement on postoperative day 29. On follow-up at two weeks, four caretakers (14%) stated their child’s pain was not well controlled upon discharge, and one caretaker (4%) called a provider within 24 hours after discharge for inadequate pain control. All caretakers acknowledged adequate preoperative education, satisfaction, and were comfortable with SDD. (Table 1)

Conclusions: Caretaker satisfaction and comfort with same-day discharge following laparoscopic G-tube placement are high, ascribed to comprehensive preoperative education and anticipatory guidance.

MeSH Keywords

gastrostomy tube; laparoscopy; tube feeding

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May 5th, 11:30 AM May 5th, 1:30 PM

Evaluating Caretaker Satisfaction with Same-Day Discharge after Gastrostomy Tube Placement

Background: Same-day discharge (SDD) after outpatient laparoscopic gastrostomy tube (G-tube) placement has been our standard institutional practice since 2017, following written and video-based preoperative education regarding G-tube use, maintenance, and exchange at the time of consultation.

Objectives/Goal: We aim to evaluate caretaker satisfaction with our same day discharge protocol following laparoscopic gastrostomy tube placement.

Methods/Design: Following IRB approval, all patients planned for SDD after G-tube placement from FebruarySeptember 2021 at a tertiary care academic center were identified. Retrospective chart review was performed to identify demographic information, successful same-day discharge or reason for postoperative admission, time to first postoperative feed, length of stay (LOS), and complications requiring emergency department evaluation, readmission, or reoperation. Telephone follow-up at two weeks postoperatively was conducted to evaluate satisfaction with the SDD protocol.

Results: Thirty-four patients were eligible for SDD postoperatively. The median age was 1.0 years [IQR 0.65,5.04], and the median weight was 9.5 kg [7.3,14.1]. Fourteen (41%) patients were previously nasogastric fed. Twentyeight (82%) patients were successfully discharged same day with a median LOS of 7.7 hours [7.0,8.3], and 6 (18%) were admitted postoperatively for either further education or persistent emesis with a median LOS of 29.0 hours [26.8,31.3]. Median time to first feed was 2.3 hours [1.6,2.8]. Six patients (18%) returned to the ED within 30 days resulting in 2 (6%) readmissions for peri-stomal erythema and fever requiring oral antibiotics and a single tube dislodgement requiring operative replacement on postoperative day 29. On follow-up at two weeks, four caretakers (14%) stated their child’s pain was not well controlled upon discharge, and one caretaker (4%) called a provider within 24 hours after discharge for inadequate pain control. All caretakers acknowledged adequate preoperative education, satisfaction, and were comfortable with SDD. (Table 1)

Conclusions: Caretaker satisfaction and comfort with same-day discharge following laparoscopic G-tube placement are high, ascribed to comprehensive preoperative education and anticipatory guidance.

 

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