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

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Abstract
Aim : Monocentric retrospective paediatric study describing indications 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 regarding 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%). Median 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 fundoplication in 45 (25.3%) patients. The proportion of patients receiving 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 simultaneously without increasing complication rate.
Keywords
TUBE PLACEMENT, PERCUTANEOUS ENDOSCOPIC GASTROSTOMY, ENTERAL NUTRITION, FUNDOPLICATION, COMPLICATIONS, PEG, complications, PEG tube, gastrostomy, buried bumper

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Chicago
Van Biervliet, Stephanie, Katrien Van Renterghem, Dirk Van de Putte, Saskia Vande Velde, Ruth De Bruyne, and Myriam Van Winckel. 2014. “Gastrostomy Use in Children: a 3-year Single Centre Experience.” Acta Gastro-enterologica Belgica 77 (1): 8–12.
APA
Van Biervliet, Stephanie, Van Renterghem, K., Van de Putte, D., Vande Velde, S., De Bruyne, R., & Van Winckel, M. (2014). Gastrostomy use in children: a 3-year single centre experience. ACTA GASTRO-ENTEROLOGICA BELGICA, 77(1), 8–12.
Vancouver
1.
Van Biervliet S, Van Renterghem K, Van de Putte D, Vande Velde S, De Bruyne R, Van Winckel M. Gastrostomy use in children: a 3-year single centre experience. ACTA GASTRO-ENTEROLOGICA BELGICA. 2014;77(1):8–12.
MLA
Van Biervliet, Stephanie, Katrien Van Renterghem, Dirk Van de Putte, et al. “Gastrostomy Use in Children: a 3-year Single Centre Experience.” ACTA GASTRO-ENTEROLOGICA BELGICA 77.1 (2014): 8–12. Print.
@article{5717214,
  abstract     = {Aim : Monocentric retrospective paediatric study describing indications 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 regarding 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\%). Median 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 {\textlangle} 0.01). 
Gastro-oesophageal reflux disease (GORD) led to Nissen fundoplication in 45 (25.3\%) patients. The proportion of patients receiving 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 simultaneously without increasing complication rate.},
  author       = {Van Biervliet, Stephanie and Van Renterghem, Katrien and Van de Putte, Dirk and Vande Velde, Saskia and De Bruyne, Ruth and Van Winckel, Myriam},
  issn         = {0001-5644},
  journal      = {ACTA GASTRO-ENTEROLOGICA BELGICA},
  language     = {eng},
  number       = {1},
  pages        = {8--12},
  title        = {Gastrostomy use in children: a 3-year single centre experience},
  volume       = {77},
  year         = {2014},
}

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