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Gastrostomy button: clinical appraisal
1Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Insights
Gastrostomy buttons are effective for long-term enteral feeding in children. Initial button placement offers longer longevity compared to replacements, with valve issues being common removal reasons.
Area of Science:
- Pediatric Gastroenterology
- Medical Device Analysis
Background:
- Gastrostomy buttons are crucial for long-term enteral nutrition in pediatric patients.
- Understanding gastrostomy button performance and longevity is essential for optimizing patient care.
Purpose of the Study:
- To evaluate the longevity and reasons for removal of gastrostomy buttons in children.
- To compare the performance of initially placed gastrostomy buttons versus those inserted into mature stomas.
Main Methods:
- Retrospective analysis of 388 gastrostomy buttons inserted in 132 pediatric patients between 1988 and 1995.
- Data collected included patient demographics, indications for feeding, button type, longevity, and reasons for removal.
- Statistical comparison of longevity between primary insertions and those into mature stomas.
Main Results:
- The average longevity for all analyzed gastrostomy buttons was 360.43 days.
- First-time primary gastrostomy button insertions demonstrated significantly longer longevity than first insertions into mature stomas.
- Subsequent button replacements had significantly shorter longevity compared to initial placements.
- Valve incompetence and leakage were the primary causes for button removal.
Conclusions:
- Gastrostomy buttons are a preferred method for long-term enteral feeding in pediatric populations.
- Optimizing initial placement techniques may improve device longevity.
- Further investigation into reducing complications like valve incompetence and leakage is warranted.
Abstract:
We retrospectively studied all gastrostomy buttons inserted in the Royal Children's Hospital, Brisbane between 1988 and 1995. One hundred and thirty-two patients (M = 60, F = 72) and 388 buttons were analysed. Intellectual handicap and cystic fibrosis comprised the majority of patients. Thirty-three patients had gastrostomy buttons inserted primarily, whereas, 99 patients received gastrostomy buttons inserted into matured gastrostomy stoma. The average longevity of all determined buttons (n = 280) was 360.43 days (SD = 310.24). The first buttons inserted primarily (n = 25) had longer longevity than the first buttons inserted into matured gastrostomy stoma (n = 82) with statistical significance. The average longevity of subsequent buttons was significantly less than the first buttons. Valve incompetence and leakage of gastric content around the shaft were the most common causes of button removal. We concluded that the gastrostomy button is the method of choice for long term enteral feeding in children.
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