Gastrostomy use in children : a 3-year single centre experience

Aim : Monocentric retrospective paediatric study describing in- dications for gastrostomy and major complications, compared to literature data as part of a quality check. Methods : Records of all gastrostomy patients consulting at the UZ Ghent paediatric gastro-enterology department between January 2007-December 2009 were reviewed in December 2010 re- garding indication, age and weight at tube insertion, insertion method, major complications and current gastrostomy tube type. Results : 178 patients were included of which 165 (93%) were placed using the endoscopic pull technique, the others were placed surgically (n = 13). Neurodevelopmental disability with oral motor dysfunction was the major indication (113, 63%). Other indications were failure to thrive due to concomitant disease (65, 37%). Medi- an age at tube insertion was 3yr (interquartile range (IQR) 0.6-9) with median tube time of 3.9 yr (IQR 1.9-7.2). Immediate complications were 1 peritonitis and 1 post-insertion fever episode. Late complications (10, 5.6%) were 1 gastrocolic -fistula,- 1- dislocation- and- 8- buried- bumpers- after- 4- yr- (range- 3.5- 10.4)-of-tube-insertion.-The-incidence-of-buried-bumper-increased significantly-with-increasing-PEG-tube-time-(P-<--0.01). Gastro-oesophageal-reflux-disease-(GORD)-led-to-Nissen-fundo- plication-in-45-(25.3%)-patients.-The-proportion-of-patients-receiv- ing a fundoplication remained about 20% over time but the time lapse-between-the-2-procedures-decreased-significantly.- Conclusion :-The-development-of-buried-bumper-is-associated-to prolonged-PEG-tube-use.-In-case-of-important-GORD-laparoscopic Nissen- procedure- and- PEG- placement- can- be- performed- simulta- neously without increasing complication rate. (Acta gastroenterol. belg., 2014, 77, 8-12).