Trends in the use of gastrostomies at a tertiary paediatric referral centre

Kvello, Morten; Åvitsland, Tone Lise; Knatten, Charlotte Kristensen; Pripp, Are Hugo; Aabakken, Lars; Emblem, Ragnhild; Björnland, Kristin

doi:10.3109/00365521.2015.1123288

Cited by 8 publications

(18 citation statements)

References 213 publications

(342 reference statements)

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“…Gastrostomy is one management option to improve daily feeding regimens, long-term nutrition and medication administration [8]. It is used across a range of indications [9][10][11][12][13] but children with neurological impairments have more frequent use [6,11,12,14] including a substantial proportion who have ID [15].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of gastrostomy insertion for children and adolescents with intellectual disability

et al. 2018

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Prof Forbes conceptualized and designed the study, was responsible for obtaining funding, reviewed and revised the manuscript, and critically reviewed the manuscript for important intellectual content regarding aspects of gastroenterology. Dr Ravikumara conceptualized and designed the study, was responsible for obtaining funding, reviewed and revised the manuscript, and critically reviewed the manuscript for important intellectual content regarding aspects of gastroenterology. A/Prof Jacoby conceptualized and designed the study, was responsible for obtaining funding, provided specialist statistical support, and reviewed and revised the manuscript. Ms Bourke collected data for the study, and critically reviewed the manuscript for important intellectual content regarding aspects of intellectual disability. Dr Srasuebkul reviewed and critically reviewed the manuscript for important intellectual content regarding aspects of intellectual disability. Prof Trollor conceptualized and designed the study, was responsible for obtaining funding, reviewed and revised the manuscript, and critically reviewed the manuscript for important intellectual content regarding aspects of intellectual disability. Dr Wilson conceptualized and designed the study, was responsible for obtaining funding, reviewed and revised the manuscript, and critically reviewed the manuscript for important intellectual content regarding aspects of pediatric medicine. Prof Nagarajan conceptualized and designed the study, was responsible for obtaining funding, reviewed and revised the manuscript, and critically reviewed the manuscript for important intellectual content regarding aspects of pediatric medicine. A/Prof Jenny Downs conceptualized and designed the study, was responsible for obtaining funding coordinated and supervised linked data collection, reviewed and revised the manuscript and was the principal investigator of the research. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Section: Introductionmentioning

confidence: 99%

Epidemiology of gastrostomy insertion for children and adolescents with intellectual disability

et al. 2018

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“…Information on gastrostomy tube use in European children is most commonly drawn from studies involving small series of patients that use various classification systems for the underlying disorders. 3,[9][10][11] The scarce epidemiological data on gastrostomy tube feeding in children with different disorders limit informed decisions in clinicians, caregivers, and affected children.…”

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confidence: 99%

Gastrostomy tube insertion in children with developmental or acquired disorders: a register‐based study

Backman

Sjögreen

2020

Develop Med Child Neuro

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Aim To describe trends in gastrostomy tube insertion in children with developmental or acquired disorders in Sweden and assess their demographic characteristics. Method Children aged 0 to 18 years with gastrostomy tube insertions recorded between 1998 and 2014 were identified in the Swedish National Patient Register. Associations between disorder type and year of surgery, as well as age at surgery, were analysed using linear regression analyses. The association between disorder type and mortality 2 years from gastrostomy tube insertion was also analysed using logistic regression analysis. Results The data for 4112 children (2182 males, 1930 females), with a median age of 2 years (interquartile range=1–8y), were analysed. Children who presented with developmental disorders were the largest group (n=3501, 85%). The most common diagnosis in children with developmental disorders was cerebral palsy (n=165, 4%). In children with acquired disorders, acute lymphoblastic leukaemia (n=117, 3%) was the most common diagnosis. Gastrostomy tube insertions increased from 1998 to 2014, with the greatest increase in children with developmental disorders, who were younger than children with acquired disorders when the gastrostomy tube was first inserted. Age at tube insertion decreased in both groups during the study period. Mortality was higher in children with acquired disorders, suggesting that gastrostomy tube insertion should be part of a palliative care approach. Interpretation Child characteristics differed depending on whether the underlying disorder was developmental or acquired, suggesting a need for clinical health care guidelines related to the specific goals of gastrostomy tube insertion. What this paper adds Gastrostomy tube insertions increased by 140% from 1998 to 2014 in Sweden. The age of children with developmental disorders decreased by 1 month per year during the study period. Children presenting with developmental disorders were younger than children with acquired disorders when the gastrostomy tube was first inserted. Mortality was higher in children with acquired disorders.

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“…This can for instance be due to previous upper abdominal surgery or radiologic or clinical findings suggesting that either bowel or liver may preclude a safe PEG insertion. 12 The LAPG procedures were performed by either two consultants or one junior doctor supervised by a consultant. A 5-mm camera was placed through the umbilicus using an open technique.…”

Section: Surgical Techniquementioning

confidence: 99%

Laparoscopic Gastrostomy Placement in Children Has Few Major, but Many Minor Early Complications

2019

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Introduction Laparoscopic gastrostomy (LAPG) is an increasingly popular alternative to more traditional gastrostomy techniques. This study evaluates early postoperative complications following LAPG and investigates risk factors for gastrostomy complications. Materials and Methods Retrospective study of patients <16 years undergoing LAPG from 2005 to 2018. Early postoperative complications (<30 days) were grouped as gastrostomy-related or general and graded according to the Clavien-Dindo classification for surgical complications. Results A total of 104 patients, of which 54 (52%) had neurological impairment (NI), were included. Median age and weight were 1.2 years (1 day–15.2 years) and 8.9 kg (3.4–36), respectively. Operating time was median 37 minutes (19–86) and shorter in the second half of the patients (46 vs. 35 minutes, p = 0.04). A total of 40 (38%) patients experienced 53 gastrostomy-related complications. Of these, seven complications needed surgical treatment; severe leakage (2), too short gastrostomy button (1), feeding difficulties (1), gastric outlet obstruction (1), omentum trapped in umbilical port sutures (1), and suspected fascial defect (1). Stoma infection and granulation tissue were reported in 13 and 12%, respectively. Tube dislodgement occurred in six patients and was managed with bedside reinsertion in all. Gastrostomy-related complications were less frequent in NI patients (46 vs 22%, p = 0.01). Conclusion LAPG is a safe procedure with few major complications, but a high rate of minor complications. Operating time declined during the study period, and NI patients had fewer gastrostomy-related complications.

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Trends in the use of gastrostomies at a tertiary paediatric referral centre

Abstract: The number of gastrostomy insertions has increased from 1994 to 2012. NDs is the most common underlying diagnosis in patients receiving a gastrostomy, PEG is the most common technique and patient characteristics have changed during the study period.

Cited by 8 publications

References 213 publications

Epidemiology of gastrostomy insertion for children and adolescents with intellectual disability

Epidemiology of gastrostomy insertion for children and adolescents with intellectual disability

Gastrostomy tube insertion in children with developmental or acquired disorders: a register‐based study

Laparoscopic Gastrostomy Placement in Children Has Few Major, but Many Minor Early Complications

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