Related Experiment Videos
Gastrostomy button placement through percutaneous gastrostomy tracts created with fluoroscopic guidance: experience
M A Borge1, T M Vesely, D Picus
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Insights
Skin level gastrostomy buttons are a safe and effective alternative for pediatric patients, utilizing existing radiologically created tracts for placement. This method offers a useful option compared to traditional gastrostomy tubes.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Interventional Radiology
Background:
- Traditional gastrostomy tubes are commonly used for enteral feeding in children.
- Radiologically created gastrostomy tracts offer potential for alternative device placement.
- Skin-level gastrostomy buttons present an alternative to traditional tubes.
Purpose of the Study:
- To evaluate the safety and efficacy of skin-level gastrostomy button placement.
- To assess the feasibility of using existing radiologically created gastrostomy tracts for button placement.
- To report the authors' experience with this technique in a pediatric population.
Main Methods:
- Fifty-two gastrostomy buttons (Bard mushroom-type and MIC-Key balloon-type) were placed in 27 pediatric patients.
- All button placements utilized pre-existing tracts created via fluoroscopically guided percutaneous gastrostomy.
- Patients were followed for an average of 13.4 months post-placement.
Main Results:
- Initial button placement was successful in 93% (25/27) of patients.
- Minor complications occurred in 19 patients, including leakage and granulation tissue.
- No major complications were reported; three patients experienced tract issues requiring repositioning or replacement.
Conclusions:
- Skin-level gastrostomy button placement is a viable and safe alternative for pediatric patients.
- Conversion to button gastrostomy using existing radiologic tracts is feasible.
- Careful attention to tract integrity and button positioning is crucial for minimizing complications.
Purpose:
The authors report their experience with skin level (button) gastrostomy placement through radiologically created gastrostomy tracts.
Patients And Methods:
Fifty-two gastrostomy buttons have been placed in 27 children (average age, 73 months; range, 9-235 months). All buttons were placed through tracts created during earlier fluoroscopically guided percutaneous gastrostomy. Fifteen Bard mushroom-type buttons and 12 MIC-Key balloon-type buttons were initially placed. Patients have been followed up for an average of 13.4 months.
Results:
Button placement was successful at the initial attempt in 25 of 27 patients (93%). Tract age at button placement averaged 18.5 weeks. The average tract length measured 3.5 cm (1.7-6.0 cm). Tract rupture and peritoneal leakage occurred in three patients; one patient had the button immediately repositioned without sequela, and the remaining two patients underwent replacement of the gastrostomy tube into the stomach and successful button placement approximately 1 week later. There were no major complications. Minor problems (leak, granulation tissue, valve malfunction, balloon breakage) occurred in 19 patients.
Conclusion:
Button gastrostomy is a useful alternative to the traditional gastrostomy tube for the pediatric population. Conversion with use of existing radiologically created tracts is possible and safe. Attention to tract integrity and proper button position is required to avoid complications.