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Fluoroscopically guided percutaneous gastrostomy in children
E S Malden1, M E Hicks, D Picus
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110.
Insights
Fluoroscopic guidance enables safe and effective percutaneous gastrostomy in pediatric patients. This minimally invasive procedure achieved a 100% technical success rate with minimal complications, ensuring successful nutritional access.
Area of Science:
- Pediatric Gastroenterology
- Minimally Invasive Surgery
- Interventional Radiology
Background:
- Establishing long-term nutritional access is crucial for pediatric patients with specific medical conditions.
- Traditional methods may carry risks or be unsuitable for certain age groups.
- Percutaneous gastrostomy offers a less invasive alternative.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous gastrostomy using solely fluoroscopic guidance in pediatric patients.
- To assess complication rates and patient tolerance for tube feeding.
- To determine the feasibility of this technique for long-term nutritional support.
Main Methods:
- Percutaneous gastrostomy was performed in 27 pediatric patients (age range: 7 months–18 years).
- Access to the stomach was exclusively guided by fluoroscopy.
- Patient outcomes, including technical success, complications, and feeding tolerance, were monitored.
Main Results:
- 100% technical success rate was achieved in all procedures.
- No major complications (death, sepsis, hemorrhage, peritonitis) were reported.
- Minor complications included local skin infection in 6 patients; 96% tolerated tube feedings well.
- Survival rate at 30 days was 96%.
Conclusions:
- Percutaneous gastrostomy under fluoroscopic guidance is a safe and effective procedure for pediatric patients.
- This method provides reliable long-term non-enteral nutritional access.
- Fluoroscopic guidance simplifies the procedure while maintaining high success and safety standards.
Abstract:
Percutaneous gastrostomy was performed in 27 patients with ages ranging from 7 months to 18 years (mean, 8 years). Patient weights ranged from 4.7 to 73 kg (mean, 25 kg). Access to the stomach was planned and achieved with only fluoroscopic guidance. The technical success rate was 100%. Major procedure-related complications including death, sepsis, hemorrhage, peritonitis, or early tube removal did not occur. The minor complication of local skin infection occurred in six patients. Twenty-six patients (96%) tolerated tube feedings well. Mean follow-up was 184 days, and median follow-up was 103 days. At 30 days, 26 patients (96%) were alive. Percutaneous gastrostomy under fluoroscopic guidance is a safe and effective method of obtaining long-term nonparenteral nutritional access in pediatric patients.