As noted about a week ago in this blog, gastrostomy tube (gtube) placement in children is much different from gtube placement in adults.
A retrospective study from Boston Children’s followed 138 patients who had PEG tube placed between 1999-2000 (JPGN 2013; 57: 663-67). The median followup was approximately 5 years.
- Median time to elective tube removal was 10.2 years.
- ~50% of patients continued with gastrostomy tube 10 years after placement.
- 11% (n=15) had at least 1 major complication related to gastrostomy placement. Major complication was defined as any unplanned adverse events requiring hospitalization, surgery (eg. fundoplication) or interventional radiology (eg. gastrojejunal tube placement). Most major complications occurred during the first 6-12 months following placement with the most common being cellulitis (n=10).
- 18% of the cohort died during the 10-year study period because of non-gastrostomy-related issues. No deaths were attributed to gastrostomy tube placement.
Bottomline: The need for gastrostomy tube placement is associated with frequent comorbidities. A significant number of patients undergoing gastrostomy tube placement experience major complications.
JPGN 2013; 57: 659-62. This prospective study of 69 patients showed that early reintroduction of feedings after gastrostomy placement, 4 hours postoperatively, was safe and compared favorably to those fed 12 hours postoperatively. Early feedings were associated with hospital duration, on average, of 6.7 hours. At this center, prophylactic antibiotics were not administered without apparent increase in infections.
JPGN 2013; 57: 668-72. This retrospective study of 77 children with feeding disorders showed that inpatient behavioral interventions are effective in transitioning children from gastrostomy tube feeding to oral feeding.
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