Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
권호 표지
DOI QR코드

DOI QR Code

Complications of Gastrostomy and Gastrojejunostomy: The Prevalence in Children

  • Thomas Gestels (Department of Pediatrics, Antwerp University Hospital) ;
  • Bruno Hauser (Department of Pediatric Gastroenterology, University Hospital Brussels) ;
  • Els Van de Vijver (Department of Pediatric Gastroenterology, Antwerp University Hospital)
  • Received : 2022.08.15
  • Accepted : 2023.01.07
  • Published : 2023.05.15
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study aimed to provide an overview of the prevalence of the complications of a gastrostomy or a gastrojejunostomy with a low-profile gastric tube in children. The study also examined the effect of presence of the gastrostomy tube on the prevalence of complications. Methods: In this cross-sectional study, parents were invited to complete an online questionnaire. Children aged 0-16 years with a low-profile gastrostomy or gastrojejunostomy tube were included in the study. Results: A total of 67 complete surveys were conducted. The mean age of the included children was seven years. The most common complications during the past week, were skin irritation (35.8%), abdominal pain (34.3%), and the formation of granulation tissue (29.9%). The most common complications during the past six months were skin irritation (47.8%), vomiting (43.4%), and abdominal pain (38.8%). Most complications occurred within the first year after gastrojejunostomy placement and gradually decreased as the duration since the placement of the gastrojejunostomy tube increased. The prevalence of severe complications was rare. Parental confidence in caring for the gastrostomy positively correlated with increases in the duration of the gastrostomy tube. Even so, parental confidence in the care of the gastrostomy tube was reduced in some parents more than a year after its placement. Conclusion: The prevalence of gastrojejunostomy complications in children is relatively high. The incidences of severe complications after the placement of a gastrojejunostomy tube were rare in this study. A lack of confidence in the care of the gastrostomy tube was noted in some parents more than a year after its placement.

Keywords

References

  1. Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, et al. Maternal and child undernutrition: consequences for adult health and human capital. Lancet 2008;371:340-57. Erratum in: Lancet 2008;371:302.
  2. Estrem HH, Pados BF, Park J, Knafl KA, Thoyre SM. Feeding problems in infancy and early childhood: evolutionary concept analysis. J Adv Nurs 2017;73:56-70. https://doi.org/10.1111/jan.13140
  3. de Onis M, Branca F. Childhood stunting: a global perspective. Matern Child Nutr 2016;12 (Suppl 1):12-26. https://doi.org/10.1111/mcn.12231
  4. Hegazi MA, Sehlo MG, Al-Jasir A, El-Deek BS. Development and cognitive functions in Saudi preschool children with feeding problems without underlying medical disorders. J Paediatr Child Health 2015;51:906-12. https://doi.org/10.1111/jpc.12880
  5. Bailey RL, West KP Jr, Black RE. The epidemiology of global micronutrient deficiencies. Ann Nutr Metab 2015;66 Suppl 2:22-33. https://doi.org/10.1159/000371618
  6. Heyland DK, MacDonald S, Keefe L, Drover JW. Total parenteral nutrition in the critically ill patient: a meta-analysis. JAMA 1998;280:2013-9. https://doi.org/10.1001/jama.280.23.2013
  7. Harkness L. The history of enteral nutrition therapy: from raw eggs and nasal tubes to purified amino acids and early postoperative jejunal delivery. J Am Diet Assoc 2002;102:399-404. https://doi.org/10.1016/S0002-8223(02)90092-1
  8. Blumenstein I, Shastri YM, Stein J. Gastroenteric tube feeding: techniques, problems and solutions. World J Gastroenterol 2014;20:8505-24. https://doi.org/10.3748/wjg.v20.i26.8505
  9. Minard G. The history of surgically placed feeding tubes. Nutr Clin Pract 2006;21:626-33. https://doi.org/10.1177/0115426506021006626
  10. Heuschkel RB, Gottrand F, Devarajan K, Poole H, Callan J, Dias JA, et al. ESPGHAN position paper on management of percutaneous endoscopic gastrostomy in children and adolescents. J Pediatr Gastroenterol Nutr 2015;60:131-41. https://doi.org/10.1097/MPG.0000000000000501
  11. Pars H, Cavusoglu H. A literature review of percutaneous endoscopic gastrostomy: dealing with complications. Gastroenterol Nurs 2019;42:351-9. https://doi.org/10.1097/SGA.0000000000000320
  12. Naing L, Winn T, Rusli BN. Practical issues in calculating the sample size for prevalence studies. Arch Orofac Sci 2006;1:9-14. 
  13. Krom H, van Zundert SMC, Otten MGM, van der Sluijs Veer L, Benninga MA, Kindermann A. Prevalence and side effects of pediatric home tube feeding. Clin Nutr 2019;38:234-9. https://doi.org/10.1016/j.clnu.2018.01.027
  14. Di Leo G, Pascolo P, Hamadeh K, Trombetta A, Ghirardo S, Schleef J, et al. Gastrostomy placement and management in children: a single-center experience. Nutrients 2019;11:1555.
  15. Kumbhar SS, Plunk MR, Nikam R, Boyd KP, Thakrar PD. Complications of percutaneous gastrostomy and gastrojejunostomy tubes in children. Pediatr Radiol 2020;50:404-14. https://doi.org/10.1007/s00247-019-04576-1
  16. Brett K, Argaez C. Gastrostomy versus gastrojejunostomy and/or jejunostomy feeding tubes: a review of clinical effectiveness, cost-effectiveness and guidelines. Ottawa: Canadian Agency for Drugs and Technologies in Health, 2018.
  17. Sandberg F, Viktorsdottir MB, Salo M, Stenstrom P, Arnbjornsson E. Comparison of major complications in children after laparoscopy-assisted gastrostomy and percutaneous endoscopic gastrostomy placement: a meta-analysis. Pediatr Surg Int 2018;34:1321-7. https://doi.org/10.1007/s00383-018-4358-6
  18. Balogh B, Kovacs T, Saxena AK. Complications in children with percutaneous endoscopic gastrostomy (PEG) placement. World J Pediatr 2019;15:12-6. https://doi.org/10.1007/s12519-018-0206-y
  19. Homer SD. Effect of education on school-age children's and parents' asthma management. J Spec Pediatr Nurs 2004;9:95-102. https://doi.org/10.1111/j.1547-5069.2004.00095.x
  20. Schor A, Bergovoy-Yellin L, Landsberger D, Kolobov T, Baron-Epel O. Multidisciplinary work promotes preventive medicine and health education in primary care: a cross-sectional survey. Isr J Health Policy Res 2019;8:50.