The Effect of Gastrostomy Placement on Health-Related Quality of Life in Children

Background and purpose: A gastrostomy placement (GP) aims to improve nutritional status and health-related quality of life (HRQoL) in children who require long-term enteral tube feeding. We evaluated the effect of GP on HRQoL. Methods: A prospective, longitudinal cohort study was performed including patients referred for laparoscopic GP. Children and/or caregivers were asked to fill out the validated PedsQL (TM) questionnaire before and 3 months after surgery. The aim was to compare preoperative with postoperative HRQoL and to identify predictors of HRQoL. Results: Fifty patients were included with a median age of 3.4 years (interquartile range 1.4-5.6). After GP, total HRQoL did not significantly increase (p = 0.30). However, psychosocial health significantly increased: 55.8 (standard deviation +/- 20.8) to 612 (+/- 19.6; p = 0.03) on a 100-point scale. This was mainly owing to an increase in social HRQoL: 582 ( +/- 32.3) to 68.3 (+/- 27.9; p = 0.04). HRQoL both before and after GP was significantly lower in children with neurologic impairment (p < 0.0005). However, neurologic impairment did not influence the effect of surgery on HRQoL (p = 0.66). Low preoperative body mass index was a predictor for improvement in HRQoL after GP. Conclusions: After GP in children, psychosocial HRQoL improved significantly. This was mainly owing to an improvement in social HRQoL. (C) 2019 Published by Elsevier Inc.