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

1
Pediatric Gastroenterology, Endoscopy and Nutrition Unit, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, via dell’Istria 65/1, 34137 Trieste, Italy
2
Pediatric Clinic, Maternal and Child Department, San Polo Hospital, Azienda Bassa Friulana-Isontina n.2 (AAS2), via Galvani 1, 34074 Monfalcone (GO), Italy
3
Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
4
Department of Paediatric Surgery, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, via dell’Istria 65/1, 34137 Trieste, Italy
5
Pediatric Department, Institute for Maternal and Child Health IRCCS, Burlo Garofolo of Trieste, via dell’Istria 65/1, 34137 Trieste, Italy
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(7), 1555; https://doi.org/10.3390/nu11071555
Received: 28 May 2019 / Revised: 4 July 2019 / Accepted: 8 July 2019 / Published: 10 July 2019
(This article belongs to the Special Issue Cerebral Palsy and Nutrition—A Global Perspective)
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Abstract

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. View Full-Text
Keywords: percutaneous gastrostomy; children; neuromuscular disease percutaneous gastrostomy; children; neuromuscular disease
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MDPI and ACS Style

Di Leo, G.; Pascolo, P.; Hamadeh, K.; Trombetta, A.; Ghirardo, S.; Schleef, J.; Barbi, E.; Codrich, D. Gastrostomy Placement and Management in Children: A Single-Center Experience. Nutrients 2019, 11, 1555.

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