Paediatric gastrostomy stoma complications and treatments: A rapid scoping review

Townley, Ashleigh; Wincentak, Joanne; Krog, Kim; Schippke, J; Kingsnorth, Shauna

doi:10.1111/jocn.14233

Cited by 19 publications

(7 citation statements)

References 41 publications

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“…As in other studies, over granulating tissue on the stoma margin was described as being particularly problematic (Kurien et al, ). There is limited research to support the management of over granulation warranting further investigation (Townley, Wincentak, Krog, Schippke, & Kingsnorth, ).…”

Section: Discussionmentioning

confidence: 99%

People with enteral tubes and their carers' views of living with a tube and managing associated problems: A qualitative interview study

Green

Townsend

Jarrett

et al. 2019

Journal of Clinical Nursing

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Background Nutrition by enteral tube is a complex therapy requiring significant management to ensure safe, timely delivery of nutrients and avoidance of complications. In the home setting, people with enteral tubes and their carers are required to self‐manage the therapy, including the need to cope with problems that arise. Whilst previous studies have conveyed experiences of people with enteral tubes, few have described views on enteral tube problems. Aims and objectives Drawing on the findings of a previously reported study (Journal of Human Nutrition and Dietetics, 2019), this paper aims to describe in‐depth the experiences of people with enteral tubes and their carers of living with the tube day to day and managing problems that arise. Design A qualitative descriptive design using semi‐structured in‐depth interviews was employed. Methods A purposive sample of 19 people with enteral tubes and 15 carers of people with tubes participated. Interviews were recorded and transcribed. Using a thematic analysis approach, codes were defined and applied; themes developed and refined. Five themes with associated subthemes were generated, of which one, “living with the tube,” is reported in‐depth. The COREQ checklist was used. Results Participants described the tube affecting both physical and psychosocial being and revealed it had resulted in significant changes to their daily living, necessitating adaptation to a new way of life. Participants reported spending much time and effort to manage tube problems, at times without support from healthcare practitioners knowledgeable in tube management. Discomfort associated with the tube was commonly described. Conclusions Living with an enteral tube impacts significantly on daily life requiring adaptations to normal routine. People with tubes and their carers use a range of strategies to manage common complications. Relevance to clinical practice Knowledge and understanding of how people with enteral tubes live with their tube and manage issues as they arise will enable healthcare practitioners to provide better support.

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Section: Discussionmentioning

confidence: 99%

People with enteral tubes and their carers' views of living with a tube and managing associated problems: A qualitative interview study

Green

Townsend

Jarrett

et al. 2019

Journal of Clinical Nursing

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“…Risk factors for granulation tissue development are friction movement at the wound interface (eg, due to poor or incorrect positioning of the external fixator); and critical colonisation or true infection. Preventive actions and management options are summarised below 2 4 8 19 25 30–32…”

Section: Overgranulation Tissuementioning

confidence: 99%

Prevention and management of minor complications in percutaneous endoscopic gastrostomy

Boeykens

Duysburgh

Verlinden

2022

BMJ Open Gastroenterol

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BackgroundPercutaneous endoscopic gastrostomy (PEG) was developed by Ponsky-Gauderer in the early 1980s. These tubes are placed through the abdominal wall mainly to administer fluids, drugs and/or enteral nutrition but can also be used for drainage or decompression. The tubes consist of an internal and external retention device. It is a generally safe technique but major or minor complications may arise during and after tube placement.MethodA narrative review of the literature investigating minor complications after PEG placement.ResultsThis review was written from a clinical viewpoint focusing on prevention and management of minor complications and documented with real cases from more than 21 years of clinical practice.ConclusionsDepending on the literature the incidence of minor complications after gastrostomy placement can be high. To decrease associated morbidity, prevention, early recognition and popper management of these complications are important.

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“…Gray literature searched included EThOS (ethos.bl.uk) and Open Grey (www.opengrey.eu). To strive for literature saturation, clinical experts were contacted in September 2020 for any further articles that could have been missed from database searches, and reference lists of included studies, relevant reviews, 30,31 and the table of contents of key journals Pediatric Blood & Cancer and Journal of Pediatric Hematology/Oncology from January 2019 (dates since the most recent nonsystematic review) 21 were scanned.…”

Section: Information Sources and Searchmentioning

confidence: 99%

Systematic review of gastrostomy complications and outcomes in pediatric cancer and bone marrow transplant

et al. 2021

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Background: Nutrition support is essential in children with cancer, including those undergoing bone marrow transplant (BMT), to reduce the risk of malnutrition and associated deleterious outcomes. Enteral nutrition is more commonly provided via nasogastric than gastrostomy tubes because of safety concerns with the latter in immunocompromised children. This systematic review investigated the incidence and type of complications and outcomes in pediatric cancer patients fed by gastrostomy. Methods: Databases were searched for randomized and observational studies investigating the use of any gastrostomy device in children aged <18 years with any cancer diagnosis, including those undergoing BMT. Five cohort and 11 case series studies were included. Owing to clinical heterogeneity, meta-analyses were not performed.Results: Quality of evidence varied, with five studies judged at serious risk of bias and poor quality; however, the remaining 11 were considered to range from moderate to good quality. Across studies, 54.6% of children developed one or more complications, of which 76.6% were classified as minor, 23.4% major. The most frequent complications included inflammation (52% of episodes), infection (42.1%), leakage (22.3%), and granuloma (21%). Evidence regarding infection rates in cancer/BMT patients compared with other disease states was inconclusive.Gastrostomy feeding was associated with improvement or stabilization of nutrition status in 77%-92.7% of children.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Paediatric gastrostomy stoma complications and treatments: A rapid scoping review

Abstract: Effective management of skin-related stoma complications is important to maintain health and wellness among children who rely on G- and GJ-tubes for nutrition support.

Cited by 19 publications

References 41 publications

People with enteral tubes and their carers' views of living with a tube and managing associated problems: A qualitative interview study

People with enteral tubes and their carers' views of living with a tube and managing associated problems: A qualitative interview study

Prevention and management of minor complications in percutaneous endoscopic gastrostomy

Systematic review of gastrostomy complications and outcomes in pediatric cancer and bone marrow transplant

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