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"Push-pull" gastrostomy: a new technique for percutaneous gastrostomy tube insertion in the neonate and young infant

A M Cahill1, R D Kaye, C R Fitz

  • 1Children's Hospital of Pittsburgh, Department of Radiology, PA 15217, USA. Cahilla@chplink.chp.edu

Pediatric Radiology
|September 12, 2001
PubMed

Insights

The "push-pull" technique safely and effectively places percutaneous gastrostomy tubes (PGT) in infants when standard methods fail. This method ensures successful PGT insertion, becoming the preferred choice for neonates and young children.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Interventional Radiology

Background:

  • Percutaneous gastrostomy tube (PGT) insertion is crucial for nutritional support in neonates and young infants.
  • Traditional antegrade PGT techniques may not be suitable for all pediatric patients.
  • A novel combined antegrade and retrograde approach, the
  • push-pull
  • technique, was developed.

Purpose of the Study:

  • To evaluate the efficacy and safety of the
  • push-pull
  • technique for PGT insertion in neonates and young infants.
  • To assess its utility in cases where standard antegrade PGT placement is challenging.

Main Methods:

  • A retrospective review of 85 pediatric patients (mean age 4.5 months) who underwent PGT insertion using the
  • push-pull
  • technique between January 1994 and December 2000.
  • Indications included failure to thrive, static encephalopathy, and congenital abnormalities.
  • Jejunostomy tubes were co-placed in 57 patients.

Main Results:

  • Successful PGT insertion was achieved in all 85 patients.
  • The
  • push-pull
  • technique successfully converted 4 initially failed antegrade placements.
  • One major complication (gastrocolic fistula) occurred and was surgically repaired; minor issues included tube dislodgement and stomal infection.

Conclusions:

  • The
  • push-pull
  • gastrostomy technique is a safe and effective method for PGT placement in neonates and young infants.
  • It offers a viable alternative when the classic antegrade method is not feasible.
  • This technique has become the preferred method for PGT insertion in this patient population.
Abstract

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