SameDay Discharge for Pediatric Laparoscopic Gastrostomy Charlene Dekonenko

Same-Day Discharge for Pediatric Laparoscopic Gastrostomy Charlene Dekonenko, MD; Wendy Jo Svetanoff, MD MPH; Obiyo O. Osuchukwu, MD MPH; Amy L. Pierce APRN; Beth A. Orrick, APRN; Kristen L. Sayers, APRN; Rebeccca M. Rentea, MD; Pablo Aguayo, MD; Jason D. Fraser, MD; David Juang, MD; Richard J. Hendrickson, MD; Charles L. Snyder, MD; Walter S. Andrews, MD; Shawn St. Peter, MD; Tolulope A. Oyetunji, MD MPH Children’s Mercy Kansas City, MO Background - Laparoscopic gastrostomy is a common procedure in children. Results N=62 Age (y) -We developed a same-day discharge (SDD) protocol Weight (kg) for laparoscopic button gastrostomy Pre-op Nasogastric Feeds Aim: To determine safety and feasibility of same day discharge following laparoscopic gastrostomy in children. Methods - Prospective observational study - Children undergoing laparoscopic gastrostomy and eligible for same-day discharge Results Operative Time (min) Time to Initiation of Feeds (hr) Successful SDD LOS (hr) 2. 1 [IQR 0. 9, 4. 1] 10. 5 [IQR 7. 6, 15. 5] 66% 22 [IQR 16, 29] 4. 4 [IQR 3. 4, 5. 5] - 22% (n=11) of SDD patients were seen in ER<30 days of surgery - 27% (n=3) of patients who were admitted postoperatively were seen in ER <30 days of surgery - p=0. 68 - Median time to ER 5 days [IQR 3, 12] - Most common reason for ER visit was mechanical complications 82% 9 [IQR 7, 10] -Eligible: no additional procedure requiring admission, -18% (n=11) patients admitted no planned admission due to medical complexity, - Median LOS 28 hr [IQR 25, 29] received pre-op gastrostomy button education - Most common reason for admission was further - Analysis in STATA, p<0. 05 significant gastrostomy button teaching Conclusion - Same day discharge following laparoscopic gastrostomy is safe and feasible for select pediatric patients who undergo pre-operative education, with no increase in post-operative emergency room visits compared to overnight hospital stay.