Guided Transabdominal U-Stitches Gastropexy: A Simplified Technique for Secure Laparoscopic Gastrostomy Tube Insertion

Background and Objective. Gastrostomy tube insertion is one of the most common procedures performed as a radical choice to overcome feeding difficulty in children. This study is aimed at describing the replacement of a button tube instead of the long tube for feeding infants and children requiring gastrostomies in a tertiary care hospital. Design and Setting. This retrospective cross-sectional descriptive study was conducted between January 2009 and August 2019 at Salmaniya Medical Complex which is a tertiary health care institute in the Kingdom of Bahrain. Subjects and Methods. Both charts and electronic health records of pediatric patients between the ages of 0 and 14 years were reviewed. Data were collected including age, sex, nationality, diagnosis, surgical information (procedure center and procedure performed), complications, and follow-up. Results. Out of 34 patients who underwent gastrostomy tube insertion, 30 patients had their long tube replaced by a button gastrostomy. Majority were males (N=18, 60%). Prolonged nasogastric tube feeding was the main indication of referral (N=17, 56%) followed by feed intolerance (N=6, 17%) and gastroesophageal reflux disease (N=5, 16%). The main underlying diseases at referral were neurological impairment (N=19, 63%) and metabolic disorders (N=4, 13%). There was no significant difference between patients with neurological disorders and other diseases in terms of gender, nationality, or age. Laparotomy with gastrostomy is the main approach used (N=18, 60%). No reported complications of button tubes in 50% of the patients (N=15). Conclusions. Prolonged nasogastric tube feeding is the main indication of referral for gastrostomy tube insertion. Neurological disorders are the main diagnosis for the cases operated upon. Laparotomy with gastrostomy is the procedure of choice at our center. Majority of patients had no reported complications of button tube replacement. These children are likely to benefit from the button tube with fewer complications.

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Overweight Motor Neurone Disease Patients with Bulbar Dysfunction: High Risk Gastrostomy Tube Insertion

10.1183/13993003.congress-2020.1959 ◽

2020 ◽

Author(s):

Angela Reddy ◽

Shauna Sheridan ◽

Reegan Puthussery ◽

Joerg Steier ◽

Eui-Sik Suh ◽

...

Keyword(s):

High Risk ◽

Motor Neurone ◽

Gastrostomy Tube ◽

Motor Neurone Disease ◽

Tube Insertion ◽

Bulbar Dysfunction

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Feasibility Study of Laparoscopic Gastrostomy Tube Placement in Beagle Dogs

Journal of Veterinary Clinics ◽

10.17555/jvc.2014.02.32.1.28 ◽

2014 ◽

Vol 32 (1) ◽

pp. 28

Author(s):

Jae-Woong Lee

Keyword(s):

Feasibility Study ◽

Gastrostomy Tube ◽

Tube Placement ◽

Beagle Dogs ◽

Laparoscopic Gastrostomy ◽

Gastrostomy Tube Placement

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Gastrostomy tube for nutrition and bowel obstruction in patients with advanced malignancy: Less is more.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.700 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 700-700

Author(s):

Gabrielle Gauvin ◽

Chi Chi Do-Nguyen ◽

Leigh T Selesner ◽

Eileen O'Halloran ◽

Johanna Lou ◽

...

Keyword(s):

Bowel Obstruction ◽

Active Treatment ◽

Negative Impact ◽

Care Center ◽

Group Versus ◽

Gastrostomy Tube ◽

Tube Placement ◽

Tube Insertion ◽

Advanced Malignancy ◽

Less Is More

700 Background: Malnutrition and malignant bowel obstruction (MBO) are common consequences of advanced malignancy. Both lead to a poor prognosis, frequent hospitalizations, and have a negative impact on quality of life. The aim of this study is to explore gastrostomy tube (g-tube) placement practices to better define the role of g-tube role in advanced malignancy. Methods: Patients who underwent g-tube placement at our tertiary cancer care center between 2013 and 2017 were included in this study. Patients’ demographics, diagnosis, procedures, postoperative course, and clinical data were collected. Complications and survival were used as endpoints. Results: Two hundred forty-two cancer patients with an average age at diagnosis of 61 years (range 21-94) underwent g-tube placement for nutrition (76.4%), decompression (MBO) (22.7%), or both (0.8%). Active treatment within 3 months of g-tube insertion was seen in 37.8% of the nutrition group versus 29.1% in the MBO group (p = 0.208). Successful insertion was achieved in 96.8% of patients, but nine patients required more than one method of insertion attempt. In the nutrition group, successful method of insertion was 88.1% in interventional radiology, 8.1% in operating room, and 3.8% in endoscopy suite, compared to 81.8%, 14.5%, and 3.6% for the MBO group, respectively (p = 0.426). Post-placement complications were significantly less common in the MBO group compared to the nutrition group (24.1 vs. 54.3%, p < 0.001). Consultation pattern in the MBO group revealed that 45.5% had a palliative care consult, 56.4% were seen by social work, and 47.3% went to hospice. Survival in the MBO group was significantly shorter than in the nutrition group at 30 days (52.7 vs. 90.3%, p < 0.001), 1-year (54.6 vs. 5.9%, p<0.001), and three years (24.1 vs 1.8%, p = 0.001) after g-tube placement. Conclusions: In our experience, most patients who undergo g-tube insertion are not receiving active treatment and a large proportion of patients who receive a decompressive g-tube have a life expectancy of less than a month. These findings will inform the next step of our study: creating a discussion tool to coordinate better care and interventional decision making for patients with advanced malignancy.

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