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Complications and effectiveness of gastrostomy feedings in pediatric cancer patients
P Mathew1, L Bowman, R Williams
1Department of Hematology/Oncology, St. Jude Children's Research Hospital, Memphis, TN 38101-0318, USA.
Insights
Gastrostomy (GT) feedings provide effective nutritional support for pediatric cancer patients, despite common minor complications. Button devices showed higher insertion site infection rates than tube devices.
Area of Science:
- Pediatric Oncology
- Gastroenterology
- Nutritional Support
Background:
- Pediatric cancer patients often require nutritional support due to weight loss and treatment side effects.
- Enteral nutrition via gastrostomy (GT) is a common method to address these needs.
Purpose of the Study:
- To evaluate the complications and effectiveness of gastrostomy (GT) feedings in children undergoing cancer treatment.
Main Methods:
- Retrospective review of medical records for 33 pediatric cancer patients receiving enteral nutrition via GT.
- Analysis of complication types, insertion techniques (tube vs. button), and nutritional outcomes.
Main Results:
- Most patients (30/33) experienced complications, primarily insertion site reactions and feeding intolerance.
- Button GTs were associated with significantly more local infections than tube GTs.
- Despite complications, 82% of patients achieved or maintained ideal body weight.
Conclusions:
- Gastrostomy feedings are effective for nutritional support in pediatric cancer patients.
- Complications are frequent but generally minor, with button devices posing a higher risk for local infection.
Purpose:
The objective of this study was to assess the complications and efficacy of gastrostomy (GT) feedings in pediatric cancer patients.
Patients And Methods:
We reviewed the medical records of 33 pediatric cancer patients who received enteral nutrition via a GT.
Results:
Median age was 9.4 years (range, 1-19.8 years), and 28 of the 33 patients had solid tumors. Seventeen patients had a significant weight loss (median, 8.5%) and therapy-related weight loss was anticipated in 16 patients. The GT device was placed an average of 5.5 months after diagnosis. Twenty-five patients were fed via a tube and eight via a button device. The tube was placed surgically in 21 cases (including all eight button types) and endoscopically in 12. Nutritional support lasted a median of 9.5 months. One or more complications occurred in 30 patients and were categorized as (a) insertion site reactions (inflammation, 23; infection/colonization, 14; exuberant granulation tissue, 6); (b) mechanical problems (leaking, 3; obstruction, 2; breakage, 1; accidental dislodgement, 2); (c) insertion site bleeding, 8; and (d) feeding intolerance, 12. Only one insertion site cellulitis progressed to a systemic infection. All eight patients with a button GT experienced insertion site complications, with local infection occurring significantly more often in patients with the button than in those with the tube GT. There were no significant associations between insertion technique and type of complication. Twenty-seven patients (82%) achieved or maintained ideal body weight with this intervention.
Conclusions:
GT feeding was associated with minor complications, but permitted effective nutritional support for pediatric cancer patients.