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Percutaneous gastrostomy tubes in children with Pierre Robin sequence: efficacy, maintenance and complications

Authors
  • Al-Attar, Hyder1, 2
  • Shergill, Arvind K.1
  • Brown, Nicole E.1
  • Guernsey, Cindy3
  • Fisher, David3
  • Temple, Michael1
  • John, Philip1
  • Amaral, Joao G.1
  • Parra, Dimitri1
  • Connolly, Bairbre L.1
  • 1 The Hospital for Sick Children, Department of Diagnostic Imaging, Image-Guided Therapy, 555 University Ave., Toronto, M5G 1X8, Canada , Toronto (Canada)
  • 2 University of Western Ontario, London, Canada , London (Canada)
  • 3 The Hospital for Sick Children, Cleft Lip and Palate Program, Toronto, Canada , Toronto (Canada)
Type
Published Article
Journal
Pediatric Radiology
Publisher
Springer-Verlag
Publication Date
Dec 01, 2011
Volume
42
Issue
5
Pages
566–573
Identifiers
DOI: 10.1007/s00247-011-2301-2
Source
Springer Nature
Keywords
License
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Abstract

BackgroundChildren with Pierre Robin sequence (PRS) have significant oropharyngeal abnormalities, with respiratory and feeding difficulties. Gastrostomy tubes (G-tube) provide a means for nutrition.ObjectiveTo evaluate the safety and efficacy of percutaneous G-tube insertion in children with PRS.Materials and methodsOf 120 children with PRS (1996–2009), 40 were referred for G-tube insertion; clinical details were reviewed in 37/40 children (18M, 19F) at three time periods: (1) pre-G-tube insertion, (2) at G-tube insertion, (3) at G-tube removal.ResultsPre-G-tube: 32/37 were term infants; 5 were preterm; 16/37 children were ≤ 10th weight percentile. At G-tube insertion, mean age was 66 days, mean weight 4.4 kg (1.1–7.0 kg); 19 dropped ≥10 weight percentiles; 12 tolerated nil by mouth; 2/37 were intubated for the procedure. All G-tubes were successfully placed, with five minor technical issues. Early postprocedure, there were eight minor complications and two dislodgements (classified as major). At G-tube removal mean G-tube dwell time was 2 years, with an average of 3.6 maintenance procedures per child, approximately 3 tube changes/1,000 tube days. At G-tube removal, 76% had maintained or increased weight centiles.ConclusionG-tubes in PRS provide a safe method for nutrition until children feed adequately by mouth.

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