To Button or Not to Button? Primary Gastrostomy Tubes Offer No Significant Advantage Over Buttons

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Medical Devices

Background:

• Gastrostomy tubes are essential for nutritional support in pediatric patients.
• The choice between gastrostomy tubes (G-tubes) and gastrostomy buttons (G-buttons) for primary placement has not been clearly established.
• Understanding complication rates is crucial for optimizing patient care.

Purpose of the Study:

• To compare the outcomes and complication rates of primary gastrostomy tubes versus gastrostomy buttons in pediatric patients.
• To test the hypothesis that primary G-tubes result in fewer complications than G-buttons.

Main Methods:

• A retrospective review of 265 pediatric patients who underwent surgically placed gastrostomy device insertion between 2010 and 2017.
• Patients were categorized into primary G-tube and primary G-button groups.
• Data on demographics, outcomes, and 90-day postoperative complications were collected and analyzed.

Main Results:

• The study included 265 pediatric patients: 80 (30.2%) received primary G-tubes and 185 (69.8%) received primary G-buttons.
• Overall complication rates within 90 days were not significantly different between the groups (G-tube 63.8% vs. G-button 55.7%, p=0.192).
• There were no significant differences in major complication rates between the primary G-tube and G-button groups (5% vs. 4%, p=0.455).

Conclusions:

• Primary gastrostomy tubes do not offer a significant advantage over gastrostomy buttons in terms of overall, minor, or major complications in pediatric patients.
• The findings suggest that either device can be chosen for primary placement without a significant difference in short-term surgical outcomes.
• Further research may explore long-term outcomes and patient/family preferences.