Trends in the use of gastrostomies at a tertiary paediatric referral centre

Scand J Gastroenterol. 2016;51(5):625-32. doi: 10.3109/00365521.2015.1123288. Epub 2015 Dec 18.

Abstract

Objectives: The aims of this study were to describe the population of paediatric patients undergoing gastrostomy placement at a Norwegian tertiary referral centre and to investigate trends over time in patient characteristics and operative technique.

Materials and methods: Patients <15 years of age getting a primary gastrostomy from 1994 to 2012 were included in this retrospective observational study. Patient data were collected from medical records and the National Registry.

Results: Six-hundred forty-nine patients with a median age of 1.2 years [gestational week 30-14.9 years] were included. Neurological disorders (ND) was the most common underlying group of diagnosis (n = 311, 48%), followed by cardiac disease 104 (16%), congenital anomalies 85 (13%), respiratory disease 43 (7%), malignancy 29 (5%), and others 77 (12%). At follow-up, 162 (25%) patients were dead. A percutaneous endoscopic technique (PEG) was used in 401 (62%) patients, open surgery (OPEN) in 201 (31%) and laparoscopy (LAP) in 47 (7%). The number of gastrostomies per year more than doubled during the period (p < 0.001). More patients with cardiac disease and congenital anomalies were given a gastrostomy during the last years (all p < 0.05), whereas the number of patients with ND remained stable. Furthermore, there has been a decrease in median age and an increase in the number of PEG and LAP (p < 0.05).

Conclusion: The number of gastrostomy insertions has increased from 1994 to 2012. NDs is the most common underlying diagnosis in patients receiving a gastrostomy, PEG is the most common technique and patient characteristics have changed during the study period.

Keywords: Enteral nutrition; PEG; gastrostomy; trends.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Endoscopy, Gastrointestinal
  • Enteral Nutrition / methods*
  • Enteral Nutrition / statistics & numerical data
  • Female
  • Gastrostomy / trends*
  • Humans
  • Infant
  • Male
  • Retrospective Studies
  • Tertiary Care Centers / statistics & numerical data*
  • Time Factors