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Gastrostomy revision: incidence and indications
Sarah J Conlon1, Tracey A Janik, Joseph S Janik
1University of Vermont School of Medicine, Burlington, VT, USA.
Journal of Pediatric Surgery
|September 11, 2004
Summary
Gastrostomy revisions occur in 6% of pediatric cases, influenced by factors like PEG placement and patient age. Understanding these risks helps improve outcomes for children requiring gastrostomy tubes.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Device Management
Background:
- Gastrostomy is a reliable procedure for pediatric feeding.
- Gastrostomy revisions are sometimes necessary.
- Risk factors for gastrostomy revision in children are not well-documented.
Purpose of the Study:
- Determine the rate of gastrostomy revision in children.
- Identify clinical factors associated with the need for gastrostomy revision.
Main Methods:
- Retrospective chart review of 1,042 children who underwent gastrostomy.
- Comparison of clinical factors between children who required revision and those who did not.
Main Results:
- 6% of children (61 out of 1,042) required gastrostomy revision.
- Factors correlating with revision included fundoplication, percutaneous endoscopic gastrostomy (PEG), gastrostomy site migration, and time.
Conclusions:
- Parents should be informed of the 6% revision risk.
- PEG, early construction (<18 months), and gastrostomy age increase revision likelihood.
- Surgical considerations include avoiding the costal margin, minimizing tract size, and optimizing nutritional status before placement in high-risk children.