الفهرس 
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Abstract
Background: A gastrostomy tube placement is a frequently performed procedure to benefit children with feeding difficulties. The majority of these children have a significant neurological impairment. Less frequent indications are an inadequate caloric intake in children with chronic medical diseases, failure to thrive, esophageal atresia, esophageal stricture. The expected advantages of laparoscopy included improved cosmetic and reduced postoperative pain and wound complications. The aim of the work : The aim of this study is to compare both open and laparoscopic gastrostomy techniques as regard the operative time, functional outcome of both techniques taking in consideration intraoperative, early postoperative and late postoperative complications. Materials & methods: The study was a prospective randomized controlled trial including 60 cases needed gastrostomy and were admitted in the Pediatric Surgery department Mansoura University Children Hospital during the period from May 2018 to May 2019. These 60 cases were divided randomly into 2 groups; group (A) open gastrostomy and group (B) laparoscopic assisted gastrostomy. Results : As regard the operative time we found that laparoscopic approach was faster. No difference in time to start feeding and time to reach full feeding. Complications was found in 15% of the study cases. It was evaluated and divided as intraoperative, early postoperative and late complications. There was no statistically important difference between the two groups in complication rate. All complications were managed effectively and safely. Intraoperative complications as gastric perforation occurred in one case of the laparoscopic group (3.3%) and conversion to open technique occurred in this case. Early postoperative complications as excessive peristomal leakage reported one case (3.3%) in the laparoscopic approach. Intraperitoneal leakage occurred in one case of each group on of them. Tube dislodgment occurred in two cases (6.7%) in open group and 3 cases 10% in laparoscopic group. Surgical site infection occurred in two cases (6.7%) in open group and one case in laparoscopic group (3.3%). Late postoperative complications as granuloma occurred in three cases in open group (10%) and four cases in laparoscopic group. persistent gastrocutanous fistula occurred in one case in open group and three cases in laparoscopic group.