Percutaneous 1-step skin-level gastrostomy tubes in infants: A safe and effective procedure

O. Elkayam, P. Ferber, M. B. Heyman, G. Herman, N. S. Adzick, M. A. Harrison, J. D. Snyder

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Skin-level gastrostomy (G) tubes are more convenient to use, eliminate protruding permanent extra-abdominal tubing and are usually preferred by most families whose children require G tubes. A one-step skin-level (OSS) G-tube has been developed which allows for placement at the time of the initial endoscopie procedure, but early reports raised concerns about the safety and efficacy in small children (Treem et al, JPGN 1994;17:382). Our initial success with this OSS in older children prompted us to evaluate its efficacy in infants. METHODS Beginning in June, 1994 patients who were > 3.0 kg and ≤ 12 months old were selected for OSS G-tube placement. All tubes were placed under general anesthesia by a team including a pediatric gastroenterologist and surgeon. A 24 French, 1.7 cm OSS (Surgitek, Racine, WI) was used in each child. Prophylactic intravenous antibiotics were administered just before and for up to 48 hours after the procedure. All patients have had subsequent follow-up in the Pediatric GI Clinic. RESULTS. 13 consecutive infants meeting the inclusion criteria have successfully received OSS G-tubes in the past 18 months. Their mean age (std dev) was 7.3 (3.1) months (range: 2 to 11 months) and their mean weight at OSS G-tube placement was 5.53 (1.8) kg. (range: 3.41 to 8.94 kg) Indications for G-tube placement included poor feeding secondary to central nervous system dysfunction (8), chromosomal abnormalities (2), and immunodeficiency (1) or the need for nocturnal feeds because of glycogen storage disease (1). The mean follow-up has been 6.6 (4.3) months. No complications occurred during the placement of the tubes and all of the tubes have functioned well. All OSS G-tube's were successfully used for feedings less than 24 hours after placement. No infections requiring systemic antibiotics have occurred and no tubes have migrated or been associated with bowel perforation. Five OSS G-tubes's have been changed to balloon skin level replacement tubes. CONCLUSION. Percutaneous 24 Fr button gastrostomy tubes can be safely and effectively placed in small infants and should be considered a standard option for G-tubes in this age group.

Original languageEnglish
Pages (from-to)326
Number of pages1
JournalGastrointestinal Endoscopy
Volume43
Issue number4
DOIs
StatePublished - 1996
Externally publishedYes

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