Long-term results of percutaneous radiologic gastrostomy and gastrojejunostomy in children with emphasis on technique: single or double gastropexy?

摘要

OBJECTIVE: The purpose of this article is to evaluate the safety and efficacy of radiologic gastrostomy and gastrojejunostomy in children, with an emphasis on the comparison of single and double gastropexy. MATERIALS AND METHODS: Between January 2000 and May 2009, a total of 91 percutaneous tubes (77 gastrostomies and 14 gastrojejunostomies) were placed in 90 patients. Patients' ages ranged from 4 months to 16.5 years. Gastropexy was performed in all cases. The first 50 children underwent double gastropexy, and 40 children underwent single gastropexy. In single gastropexy, two different punctures were performed each for the anchor and the tube. Differences in the incidence of major and minor complications and tube maintenance problems between the single- and double-gastropexy groups were retrospectively analyzed by use of Fisher's exact test. RESULTS: The technical success rate was 100%. No procedure-related mortality or morbidity was detected. The overall major and minor complication rates were 4.4% and 16.7%, respectively. The mean follow-up period was 463 days. Twenty-nine tube maintenance problems were detected in 17 patients. There were four major complications (two cases of aspiration pneumonia and two site infections that required hospitalization). Minor complications occurred in 15 patients (nine localized site infections, two cases of gastroesophageal reflux, and four tube maintenance problems requiring secondary intervention). In total, 26 and 22 complications and tube maintenance problems occurred in the single- and double-gastropexy groups, respectively. No statistically significant difference was detected between the two groups in terms of complications (p > 0.005). CONCLUSION: Radiologic gastrostomy and gastrojejunostomy are safe and effective methods for long-term nutritional support in children. Single gastropexy should be performed with two different punctures for each retention suture and the tube.