Size Matters: Early Gastrostomy Tube Dislodgment in Children

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Medical Device Research

Background:

• Gastrostomy tube (g-tube) complications are usually minor, but dislodgment before tract establishment can be major.
• The adoption of 12F g-tubes necessitates evaluation of their efficacy and dislodgment rates.
• Limited research exists on 12F vs. 14F g-tube dislodgment within the early post-surgery window (<42 days).

Purpose of the Study:

• To compare the early dislodgment rates of 12F and 14F gastrostomy tubes.
• To assess the impact of g-tube size on dislodgment within 42 days post-surgery.
• To evaluate patient age in relation to g-tube size and early dislodgment.

Main Methods:

• Retrospective study from June 2013 to May 2020, analyzing 835 patient encounters.
• Identified a subset of 21 patients for early dislodgment status evaluation.
• Utilized Fisher's exact test and Welch's two-sample test for statistical significance (P < .05).

Main Results:

• The overall early dislodgment rate was 2.5% (21/835 patients).
• G-tube size significantly impacted dislodgment rates; 12F tubes were nearly four times more likely to dislodge than 14F tubes before six weeks.
• Patients with dislodged 12F tubes were significantly younger on average than those with dislodged 14F tubes.

Conclusions:

• A significant difference exists in early dislodgment rates and patient age between 12F and 14F g-tubes.
• The smaller balloon size of 12F g-tubes may contribute to higher dislodgment rates.
• Findings suggest a potential limitation in the use of 12F g-tubes for younger, smaller pediatric patients.