469 Evaluating the Use of Laparoscopic-Assisted Gastrostomy Tube Insertion in Children with Epidermolysis Bullosa: A Retrospective Observational Study

Abstract Introduction Nutritional management of children with epidermolysis bullosa (EB) presents multiple challenges including reduced oral intake and mucosal fragility. Laparoscopic-assisted gastrostomy (LAG) tube feeding is effective in improving nutritional status. We aim to review the effectiveness morbidity our minimally invasive laparoscopic-assisted approach EB patients. Method A retrospective, observational cohort study was conducted on all patients who underwent LAG insertion between 2009 2019. Patient demographics, admission details 12-month clinical outcomes were reported. Results 31 placement. Median age at 7.2 (IQR ± 6.5) years, 8 (25.8%) 3 (9.7%) requiring oesophageal dilatation fundoplication, respectively. 71.4% experienced minor complications including: overgranulation (35.7%), infection (32.1%), pain (21.4%), mild leakage (17.9%), blockage (10.7%) late displacement (3.6%). 6 (21.4%) developed major extensive site leakage. Only one patient required laparoscopic refashioning for stoma prolapse six years post-insertion. No cases gastrostomy-related mortality recorded an improvement both mean weight height Z-scores observed. Conclusions well-tolerated improvements growth minimal 12-months post-gastrostomy insertion. An extended follow-up period ascertain long-term impacts feeding.