Gastrostomy Tubes

Abstract

The first successful gastrostomy was performed 130 years ago. Although it is difficult to ascertain the exact number of gastrostomy or jejunostomy tubes placed annually in the United States, it is estimated approximately 230,000 gastrostomy procedures were performed in U.S. hospitals in 2001. Of these, 11,000 were performed in children. Despite the many years gastrostomy tubes have been in use, they are not free from complications. The purpose of this article is to review the authors' experience with pediatric patients who have undergone radiographic placement of gastrostomy or jejunostomy tubes.

Paediatric gastrostomy stoma complications and treatments: A rapid scoping review

“…Antimicrobials Topical antibiotics (Chand, 2004;Fr€ ohlich et al, 2010;Goldberg et al, 2005;Heuschkel et al, 2015;Lee & Spratling, 2014;Lewis et al, 2008;Puntis, 2009;Soscia & Friedman, 2011) -Mupirocin (Goldberg et al, 2005;Soscia & Friedman, 2011) -Bacitracin/Polymyxin B (Soscia & Friedman, 2011) -Fucidin (Soscia & Friedman, 2011) -Cadexomer Iodine and foam dressing (Puntis, 2009) Oral antibiotics (Baker et al, 2013;Brook, 2002;Franken et al, 2015;Goldberg et al, 2005Goldberg et al, , 2010Heuschkel et al, 2015;Lee & Spratling, 2014;Puntis, 2009;Soscia & Friedman, 2011) -Cephalexin (Goldberg et al, 2005 (Soscia & Friedman, 2011) to several days with concurrent use of an alternative feeding method such as a nasoduodenal catheter (Franken et al, 2015). In terms of tube replacement, some authors suggested temporarily inserting a smaller tube to prevent full closure (Goldberg et al, 2005). Additionally, several expert opinion papers strongly cautioned against inserting wider tubes to avoid the risk of further enlarging the stoma (Lukish, 2010;Puntis, 2009).…”

“…Topical steroids (Crawley-Coha, 2004;Fr€ ohlich et al, 2010;Goldberg et al, 2005Goldberg et al, , 2010Hannah & John, 2013;Heuschkel et al, 2015;Lukish, 2010;Puntis, 2009;Rogers, 2004) -Triamcinolone cream -0.1% (Crawley-Coha, 2004;Goldberg et al, 2005Goldberg et al, , 2010Rogers, 2004) -0.5% (Crawley-Coha, 2004;Rogers, 2004) -Hydrocortisone 1% (Lukish, 2010;Puntis, 2009) -Fludroxycortide (Puntis, 2009) -Mometasone (Puntis, 2009) Oedema management Salt (Friedman, 2004;Soscia & Friedman, 2011;Tanaka et al, 2013) -Sprinkling salt (Tanaka et al, 2013) -Saline compresses (Friedman, 2004;Soscia & Friedman, 2011) Dressings (Chand, 2004;Crawley-Coha, 2004) -Polyurethane foam (Chand, 2004;Crawley-Coha, 2004) Stomahesive powder (Goldberg et al, 2005(Goldberg et al, , 2010) -…”

“…Surgery (Backman et al, 2006;Crawley-Coha, 2004;Fascetti-Leon et al, 2012;Franken et al, 2015;Goldberg et al, 2005;Heuschkel et al, 2015;Lukish, 2010) -Site revision (Goldberg et al, 2005) -Sharp debridement (Backman et al, 2006;Crawley-Coha, 2004;Fascetti-Leon et al, 2012;Franken et al, 2015;Lukish, 2010) Cryotherapy (Fr€ ohlich et al, 2010;Heuschkel et al, 2015) -Silver nitrate (Baker et al, 2013;Cahill, 2012;Chand, 2004;Crawley-Coha, 2004;Fascetti-Leon et al, 2012;Franken et al, 2015;Friedman, 2004;Fr€ ohlich et al, 2010;Goldberg et al, 2005Goldberg et al, , 2010Hannah & John, 2013;Heuschkel et al, 2015;Lewis et al, 2008;Lukish, 2010;Soscia & Friedman, 2011) -Silver nitrate and a topical barrier (Chand, 2004;Fascetti-Leon et al, 2012;Goldberg et al, 2005;Heuschkel et al, 2015;Puntis, 2009;Soscia & Friedman, 2011) -Silver nitrate, saline soaks, 1% dimethicone topical ointment (Lewis et al, 2008) (Heuschkel et al, 2015). Soscia and Friedman (2011) outlined topical antibiotic and topical antiseptic treatments as the first-line therapy for bacterial infections followed by oral antibiotics as a second-line therapy.…”