Gastrostomy revision: Incidence and indications
Section snippets
Materials and methods
A retrospective chart review was performed on the charts of children who underwent gastrostomy at The Children’s Hospital, Denver, Colorado, between 1992 and 2002. Charts of children who had a gastrostomy revision were analyzed for age at initial surgery, disease precipitating gastrostomy insertion (neurologic, reflux, nonreflux gastrointestinal, renal), type of surgery (open, percutaneous endoscopic gastrostomy [PEG], laparoscopic, laparoscopic assisted), indication for revision, time elapsed
Results
There were 1,042 children who had gastrostomy performed and who had sufficient data and follow-up for inclusion in this study. The indications for revision and the results of this study are tabulated in Table 1, Table 2, Table 3, Table 4, Table 5. Of the 1,042 gastrostomies performed, 605 were still actively in use at the time of data collection; 437 were no longer needed and either closed spontaneously after tube removal or closed surgically. Follow-up of these 1,042 children with
Discussion
Historically, gastrostomy has been associated with a myriad of complications ranging from minor skin irritation to death.1, 2, 3, 4, 5, 6, 7, 8 Clinical experience and technical modification have virtually eliminated death, hemorrhage, esophageal perforation, and other dire complications.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 Improvements in gastrostomy appliances17, 18 have made complications, such as obstruction of the duodenum by a long tube sliding from the stomach into the
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