Same-Day Discharge for Elective Pediatric Laparoscopic Gastrostomy Tube Insertion is Safe and Increasing in Frequency; A NSQIP Pediatric Retrospective Review 2017 to 2021

Infographic · Feb 2025 · 1 min read

In brief

NSQIP-P analysis of 5,947 elective pediatric laparoscopic gastrostomy cases (2017-2021) shows same-day discharge rates doubled from 2.7% to 6.3% without increased readmissions or complications. Preoperative steroid use doubled complication risk, but non-steroid patients can safely undergo same-day discharge.

Same-day discharge after elective pediatric laparoscopic G-tube placement is safe with no increase in 30-day readmission or reoperation rates.
National same-day discharge rates doubled from 2.7% to 6.3% between 2017-2021, indicating growing acceptance of outpatient approach.
Preoperative steroid use within 30 days doubles the risk of complications and readmission, warranting overnight observation in these patients.
All patients requiring reoperation within 3 days were identified before discharge, supporting careful same-day assessment protocols.
In non-steroid users, same-day discharge is a viable option that may reduce healthcare costs without compromising patient safety.

Written by the GCMD Library team from the infographic.

A four-panel medical illustration arranged horizontally showing the progression of in utero myelomeningocele repair. Each panel contains anatomical drawings in muted colors (beige, pink, blue) depicting the fetus, surgical site, and repair technique. The panels flow left to right showing: initial defect identification, surgical access, repair procedure, and post-repair closure. Small icons and arrows guide the viewer through the sequence.

John M. Woodward, Caitlin Chunco, Stephanie F. Brierley, Krystle Bittner, Hector Osei, Carroll M. Harmon, P. Benson Ham, III

Background: There is limited literature reviewing same-day discharge for elective pediatric gastrostomy tube placement. Our aim was to assess the outcomes and national trends of same-day discharge following elective pediatric laparoscopic gastrostomy.

Methods: ACS NSQIP-P registry data from 2017 to 2021 was used to evaluate elective pediatric laparoscopic gastrostomy patients who presented from home and discharged home with a diagnosis of failure to thrive, feeding difficulty or dysphagia. Patients discharged same-day postoperatively (SDD) were compared to those discharged 1-2 days postoperatively (non-SDD) for the primary outcome of unplanned 30-day readmission. Secondary outcomes included bleeding events, wound infection, and 30-day reoperation.

Results: There were 5,947 patients identified; 4.7% were discharged same-day. The annual rate of SDD over 5 years went from 2.7% to 4.6%-4.8% to 4.5%-6.3%. There were no significant differences between SDD and non-SDD patients for early readmission or reoperation (0.7% vs 0.3%, p = 0.279), 30-day unplanned readmission (8.5% vs 8.0%, p = 0.407), reoperation (0.1% vs 1.4%, p = 1.000), or any other complications (p > 0.05). Binary logistic regression found pre-operative steroid use within 30 days increased risk of serious complication (OR 2.02, 95% CI 1.29-3.15, p = 0.002) and 30-day readmission or reoperation (OR 2.10, 95% CI 1.34-3.27, p = 0.001). All 6 patients (0.1%) who required reoperation within 3 days were identified prior to discharge, and none of the 16 patients readmitted within 3 days of surgery required reoperation.

Conclusion: Though rates of same-day discharge following pediatric gastrostomy tube placement are low, they continue to increase annually. There were no significant differences in outcomes between same-day and non-same-day day discharge for elective cases presenting from and discharging home. In non-steroid using patients, same-day discharge following laparoscopic gastrostomy can be a safe option.

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