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Gastrostomy Placement and Management in Children: A Single-Center Experience

BACKGROUND: To prevent malnutrition and food aspiration in children with chronic neuromuscular problems, enteral nutrition provided by gastrostomy is recommended. Long-term follow-up data about surgical and medical complications of PEG are available, but few papers have addressed all of the issues i...

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Autores principales: Di Leo, Grazia, Pascolo, Paola, Hamadeh, Kamar, Trombetta, Andrea, Ghirardo, Sergio, Schleef, Jurgen, Barbi, Egidio, Codrich, Daniela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683077/
https://www.ncbi.nlm.nih.gov/pubmed/31295800
http://dx.doi.org/10.3390/nu11071555
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author Di Leo, Grazia
Pascolo, Paola
Hamadeh, Kamar
Trombetta, Andrea
Ghirardo, Sergio
Schleef, Jurgen
Barbi, Egidio
Codrich, Daniela
author_facet Di Leo, Grazia
Pascolo, Paola
Hamadeh, Kamar
Trombetta, Andrea
Ghirardo, Sergio
Schleef, Jurgen
Barbi, Egidio
Codrich, Daniela
author_sort Di Leo, Grazia
collection PubMed
description BACKGROUND: To prevent malnutrition and food aspiration in children with chronic neuromuscular problems, enteral nutrition provided by gastrostomy is recommended. Long-term follow-up data about surgical and medical complications of PEG are available, but few papers have addressed all of the issues in the same series. METHODS: This retrospective study enrolled patients under 18 years who had a gastrostomy tube placed at our institution between 2003 and 2017. The aim is to evaluate outcomes after gastrostomy placement, focusing both on surgical complications (early and late), and its effect on their nutritional status, on the prevention of pulmonary infections, and their parents’ opinion. RESULTS: Eighty-four gastrostomies were placed in total (35 F; 49 M). Seventy-seven patients had a severe neurocognitive impairment (GMFCS 5). The principal indication for gastrostomy was severe dysphagia (53.3%). No gastrostomy-related death was observed. Early surgical complications were observed in five of 84 (5,9%) patients; late complications were observed in 15 of 84 (17.8%) patients. Twenty-two patients were diagnosed with subsequent gastroesophageal reflux; five patients developed dumping syndrome (6%). Complete medical follow-up data were available for 45 patients. A progressive improvement of nutritional status was observed in 29 patients, and 11 maintained the same percentile; the occurrence of respiratory infections and need for hospitalization decreased. In 90% of cases, parents were fully satisfied with the g-tube. CONCLUSION: This study confirms the positive nutritional outcomes of gastrostomy-tube with an associated small risk of surgical complications and a reduction in the number of respiratory infections, with most parents scoring their experience as positive.
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spelling pubmed-66830772019-08-09 Gastrostomy Placement and Management in Children: A Single-Center Experience Di Leo, Grazia Pascolo, Paola Hamadeh, Kamar Trombetta, Andrea Ghirardo, Sergio Schleef, Jurgen Barbi, Egidio Codrich, Daniela Nutrients Article BACKGROUND: To prevent malnutrition and food aspiration in children with chronic neuromuscular problems, enteral nutrition provided by gastrostomy is recommended. Long-term follow-up data about surgical and medical complications of PEG are available, but few papers have addressed all of the issues in the same series. METHODS: This retrospective study enrolled patients under 18 years who had a gastrostomy tube placed at our institution between 2003 and 2017. The aim is to evaluate outcomes after gastrostomy placement, focusing both on surgical complications (early and late), and its effect on their nutritional status, on the prevention of pulmonary infections, and their parents’ opinion. RESULTS: Eighty-four gastrostomies were placed in total (35 F; 49 M). Seventy-seven patients had a severe neurocognitive impairment (GMFCS 5). The principal indication for gastrostomy was severe dysphagia (53.3%). No gastrostomy-related death was observed. Early surgical complications were observed in five of 84 (5,9%) patients; late complications were observed in 15 of 84 (17.8%) patients. Twenty-two patients were diagnosed with subsequent gastroesophageal reflux; five patients developed dumping syndrome (6%). Complete medical follow-up data were available for 45 patients. A progressive improvement of nutritional status was observed in 29 patients, and 11 maintained the same percentile; the occurrence of respiratory infections and need for hospitalization decreased. In 90% of cases, parents were fully satisfied with the g-tube. CONCLUSION: This study confirms the positive nutritional outcomes of gastrostomy-tube with an associated small risk of surgical complications and a reduction in the number of respiratory infections, with most parents scoring their experience as positive. MDPI 2019-07-10 /pmc/articles/PMC6683077/ /pubmed/31295800 http://dx.doi.org/10.3390/nu11071555 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Di Leo, Grazia
Pascolo, Paola
Hamadeh, Kamar
Trombetta, Andrea
Ghirardo, Sergio
Schleef, Jurgen
Barbi, Egidio
Codrich, Daniela
Gastrostomy Placement and Management in Children: A Single-Center Experience
title Gastrostomy Placement and Management in Children: A Single-Center Experience
title_full Gastrostomy Placement and Management in Children: A Single-Center Experience
title_fullStr Gastrostomy Placement and Management in Children: A Single-Center Experience
title_full_unstemmed Gastrostomy Placement and Management in Children: A Single-Center Experience
title_short Gastrostomy Placement and Management in Children: A Single-Center Experience
title_sort gastrostomy placement and management in children: a single-center experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683077/
https://www.ncbi.nlm.nih.gov/pubmed/31295800
http://dx.doi.org/10.3390/nu11071555
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