Complications associated with image-guided gastrostomy and gastrojejunostomy tubes in children

被引:90
|
作者
Friedman, JN
Ahmed, S
Connolly, B
Chait, P
Mahant, S
机构
[1] Univ Toronto, Div Pediat Med, Toronto, ON, Canada
[2] Univ Toronto, Pediat Outcomes Res Team, Toronto, ON, Canada
[3] McGill Univ, Dept Family Med, Montreal, PQ H3A 2T5, Canada
[4] Hosp Sick Children, Dept Diagnost Imaging, Toronto, ON M5G 1X8, Canada
[5] Univ Toronto, Dept Pediat, Toronto, ON, Canada
关键词
gastrostomy tube; gastrojejunostomy tube; image-guided; complications;
D O I
10.1542/peds.114.2.458
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective. To evaluate the complications associated with the image-guided insertion of gastrostomy ( G) and gastrojejunostomy (GJ) tubes in children, performed by the retrograde percutaneous route. Methods. A convenience sample of 208 charts of 840 patients recorded as having G and/or GJ tubes placed by the interventional radiology service in a 4-year period (1995-1999) at the Hospital for Sick Children in Toronto, Canada, were selected for review. Complications were categorized as major ( including subcutaneous abscess, peritonitis, septicemia, gastrointestinal bleeding, and death) or minor. Results. In total, 253 tubes ( 208 G tubes, 41 GJ tubes, 4 G and GJ tubes) were placed in the 208 patients reviewed. The median age at the time of insertion was 15 months (range: 7 days-18 years). The most common diagnostic category was neurologic disease (47%). The main indications for tube insertion were recorded as failure to thrive (57%) and risk of aspiration (47%). Major complications were seen in 5% of patients. Peritonitis was noted in 3%, and there was 1 death related to tube insertion (0.4%). Minor complications were found in 73% of patients, including tube dislodgement (37%), tube leakage (25%), and G-tube site skin infection ( 25%). GJ tubes had a higher rate than G tubes of obstruction, migration, dislodgement, leakage, and intussusception. Site infection, gastroesophageal reflux, and bleeding from the site were seen less frequently in patients with GJ tubes compared with G tubes. Conclusion. G and GJ tubes placed by the image-guided retrograde percutaneous method are associated with a wide range of complications. The majority of these are minor and are predominantly related to tube maintenance, but major complications, including death, do occur.
引用
收藏
页码:458 / 461
页数:4
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