Evaluating the use of laparoscopic-assisted gastrostomy tube feeding in children with epidermolysis bullosa: A single-center retrospective study
| Autor: | Dawn James, Rosie Jones, Aishah Zubaida Mughal, Giampiero Soccorso, Thejasvi Subramanian, Malobi Ogboli |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Gastrostomy tube feeding Enteral Nutrition medicine Humans Child Device failure Retrospective Studies Gastrostomy business.industry Infant Retrospective cohort study General Medicine medicine.disease Surgery Single centre Pediatrics Perinatology and Child Health Gastrostomy site Laparoscopy Epidermolysis bullosa Epidermolysis Bullosa business Cohort study |
| Zdroj: | Journal of Pediatric Surgery. 57:39-44 |
| ISSN: | 0022-3468 |
| Popis: | Background Nutritional management of children with epidermolysis bullosa (EB) presents multiple challenges including reduced oral intake compounded by mucosal fragility. Gastrostomy tube feeding is effective in improving nutritional status however there is limited data on the safety and tolerance of this technique in EB children. We aim to review the effectiveness and morbidity of our minimally invasive two-port laparoscopic-assisted gastrostomy (LAG) approach using Seldinger techniques with serial dilatations in children with EB. Methods A retrospective, observational cohort study was conducted on all consecutive EB patients who underwent LAG tube insertion between 2009-2019. Patient demographics, admission details and 12-month clinical outcomes were reported. Results 32 EB patients underwent LAG placement. Median age at insertion was 7.3 (IQR ± 6.3) years, with 8 (25.0%) and 3 (9.4%) of patients also undergoing oesophageal dilatation and fundoplication, respectively. Minor complications arose in 58.1% of patients including: peri-stomal overgranulation (25.8%), gastrostomy infection (22.6%), pain (22.6%), mild gastrostomy leakage (16.1%), blockage (9.7%) and device failure (3.2%). 2 patients (6.5%) developed major complications with extensive gastrostomy site leakage. Improvements in growth were reflected in mean height Z-scores (-1.99 to -1.71). Mean weight Z-scores improved in patients aged 0-10 years (-2.30 to -1.61) and mean BMI Z-scores increased in patients over 10 years (-2.71 to -1.46). No cases of gastrostomy-related mortality were reported. Conclusion LAG is well-tolerated in EB patients with improvements in growth and minimal morbidity 12-months post-gastrostomy insertion. An extended follow-up period is required to ascertain the long-term implications of gastrostomy feeding. |
| Databáze: | OpenAIRE |
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