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Published on: March 20, 2017
Gastrostomy techniques and devices
1Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Insights
Percutaneous endoscopic gastrostomy is a safe and effective method for feeding children. Utilizing a gastrostomy button minimizes catheter issues, but careful patient selection and follow-up are crucial.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Devices
Background:
- Gastrostomies are vital for managing pediatric surgical and nonsurgical conditions.
- Various techniques and devices exist for gastrostomy placement.
- Catheter-related complications are a concern with traditional gastrostomy methods.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous endoscopic gastrostomy (PEG) in children.
- To highlight the benefits of the gastrostomy button in reducing complications.
- To emphasize the importance of patient selection and multidisciplinary care in gastrostomy management.
Main Methods:
- Review of experience with percutaneous endoscopic gastrostomy.
- Focus on the use of the gastrostomy button device.
- Emphasis on preoperative assessment and long-term follow-up protocols.
Main Results:
- Percutaneous endoscopic gastrostomy demonstrated safety and effectiveness in pediatric patients.
- The gastrostomy button significantly reduced catheter-related problems.
- Careful patient selection and technical precision are key to successful outcomes.
Conclusions:
- Percutaneous endoscopic gastrostomy, particularly with a gastrostomy button, offers a safe and effective solution for pediatric feeding.
- Meticulous patient selection, preoperative evaluation for reflux, and diligent follow-up are essential.
- A collaborative approach involving healthcare professionals and families minimizes long-term morbidity, especially stoma-related issues.
Abstract:
Gastrostomies play an important role in the management of a wide variety of surgical and nonsurgical conditions of childhood. Many techniques and gastrostomy devices are available. In our experience, percutaneous endoscopic gastrostomy has proved safe and effective, and the gastrostomy button has eliminated most of the catheter-related problems. Candidates for gastrostomy, particularly children with foregut dysmotility, must be carefully selected, undergo preoperative studies aimed at determining the degree of gastroesophageal reflux, and have appropriate long-term follow-up. Attention to technical detail is essential to avoid operative complications. A good working relationship between the surgeon, gastroenterologist, nurse, and patient's family is essential to minimize long-term morbidity, particularly stoma-related problems.
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Ostomy Care
An ostomy is a surgical procedure that creates an artificial opening from the intestines to the outside of the body, allowing for the rerouting of effluent. This opening is known as a stoma. A stoma usually protrudes above the skin surface, appearing pink or red, moist, and round, and it lacks nerve sensations.
There are different types of ostomies, including colostomies, ileostomies, and urostomies:

