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Updated: Oct 29, 2025
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Patient selection for pediatric gastrostomy tubes: Are we placing tubes that are not being used?
Jordan E Jackson1, Christina M Theodorou1, Olivia Vukcevich1
1University of California-Davis, Department of Surgery, Sacramento, CA, USA.
Insights
Fifteen percent of pediatric gastrostomy tubes (GTs) were short-term. Adolescents and patients with traumatic brain injury (TBI) were more likely to receive short-term GTs, with a third needing fistula closure.
Area of Science:
- Pediatric Gastroenterology
- Surgical Outcomes
- Medical Device Utilization
Background:
- Gastrostomy tube (GT) placement in pediatric patients presents challenges in identifying appropriate candidates.
- A hypothesis suggested that a significant number of GTs might be removed within six months of placement.
Purpose of the Study:
- To evaluate the duration of gastrostomy tube (GT) use in pediatric patients.
- To identify patient demographics and clinical factors associated with short-term GT utilization.
- To assess complications and resource utilization related to short-term GTs.
Main Methods:
- Retrospective analysis of inpatient GT placements in patients under 18 years old.
- Data collected from September 2014 to February 2020 at a tertiary children's hospital.
- Primary outcome: GT use for less than six months; secondary outcomes: age, indication, and GT-related operations.
Main Results:
- 15% of pediatric GTs were used for less than six months (short-term).
- Short-term GTs were more frequent in adolescents (≥12 years) and patients with traumatic brain injury (TBI).
- 33.3% of short-term GT patients required gastrocutaneous fistula closure, incurring significant hospital charges.
Conclusions:
- A notable proportion of pediatric GTs are utilized short-term, particularly in adolescents and TBI patients.
- Short-term GT use is associated with complications like gastrocutaneous fistula requiring surgical intervention.
- Consideration of nasogastric tube (NGT) feeding may be a preferable alternative to surgical GT placement for selected pediatric populations.
Introduction:
Identifying pediatric patients who may benefit from gastrostomy tube (GT) placement can be challenging. We hypothesized that many GTs would no longer be in use after 6 months.
Methods:
Inpatient GT placements in patients < 18 years old at a tertiary children's hospital from 9/2014 to 2/2020 were included. The primary outcome was GT use <6 months (short-term). Secondary outcomes included age at placement, indication for GT, and operations for GT-related issues.
Results:
Fifteen percent (22/142) of GTs were used for <6 months post-operatively. The median duration of short-term GT use was 1.6 months (IQR 0.9-3.4 months). Short-term GTs were more likely to be placed in patients with traumatic brain injury (TBI) (18.2% vs. 4.2%, p = 0.03) and adolescents (≥12 years old, 22.7% vs. 4.0%, p = 0.005). Gastrocutaneous fistula closure was required in 33.3% of short-term patients who had their GTs removed (n = 6/18), with median total hospital charges of $29,989 per patient.
Conclusion:
Fifteen percent of pediatric GTs placed as inpatients were used for <6 months, more commonly among adolescents and in TBI patients. One-third of patients with short-term GTs required gastrocutaneous fistula closure. Adolescents and TBI patients may benefit from consideration of short-term nasogastric tube (NGT) feeds rather than surgical GT placement.
Level Of Evidence:
III.
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