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Longevity of balloon-stabilized skin-level gastrostomy device
Laurent Michaud1, Dominique Guimber, Anne-Sophie Blain-Stregloff
1Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Faculty of Medicine and Children's Hospital, Lille, France. l-michaud@chru-lille.fr
Objective:
The gastrostomy button is increasingly used in patients requiring long-term enteral feeding. No data are available addressing the longevity of balloon-type gastrostomy buttons. The aim of this study was to evaluate the longevity of balloon-type gastrostomy buttons in children and the cause of the button removal.
Patients And Methods:
During a period of 2.5 years, 165 gastrostomy (Mic-Key, Medical Innovations Corporation, Draper, Utah, U.S.A.) buttons were inserted in 84 children. In all patients, the button replaced a standard tube gastrostomy. The first button was usually inserted under general anesthesia at least 2 months after the insertion of a surgical gastrostomy tube. Additional replacement was performed without sedation.
Results:
Mean longevity of balloon-type gastrostomy buttons was 5 months (range, 14 days-14 months). Causes of button removal were: inner balloon rupture (n = 101, 61%); leak around button or deflation of the balloon (n = 23, 14%); accidental removal (n = 20, 12%); device damage (n = 5), and obstruction (n = 3). When considering the subgroup with inner balloon rupture, the longevity of the button was 6 months (range, 1-13 months). No correlation was found between duration of gastrostomy button and underlying disease, age of the patient, or the use of antisecretory drugs.
Conclusion:
Although the Mic-Key button has the advantage of an easy insertion, its major limitation is the high frequency of inner balloon rupture, which was the primary main reason for removal.