Review ArticleMitigation of stomach dehiscence risk during gastrostomy tube changes – a retrospective analysis of patient outcomes
Section snippets
Methods
Records of all patients that underwent G-tube changes through GLPS were retrospectively reviewed for an almost 18-year period between August 1998 and June 2016. All procedures were performed by the senior author in the GLPS office, at Lutheran Hospital, or Parkview Hospital in Fort Wayne, IN. All procedures that included complex tubes, such as GJ, NJ, or J-tubes, were excluded from the data pool. Demographics and related complications were abstracted from the medical records. Data collected
Results
There was no significant difference for any conversion class based on age of patient or gender. Conversions of PEG tubes vs. other tube types occurred at a significantly younger age of site (p < 0.0001), consistent with accepted trends and recommendations of using PEG tubes for initial insertion followed by change after one month, as illustrated in Fig. 1.
Overall, the changes showed a 1.28% rate of severe complication, as seen in Fig. 2 and Table 2. PEG changes showed a higher overall
Complications of button gastrostomy tube changes
Balloon tipped button gastrostomy tubes are popular because of their ease of tube exchange. These tubes last 6–9 months, requiring more frequent changes versus the mushroom tipped button tubes that last 18 months to 2 years. Increased expense related to frequent tube changes is often justified by zealous sales representatives citing less risk to the patient during the exchanges of balloon tubes. Our study demonstrates that there is no significant difference in any complication class between
Funding sources
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Acknowledgements
Great Lakes Pediatric Surgeons, Inc. staff for their assistance with charts.
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Present Address: Student, Marian University College of Osteopathic Medicine, 3200 Cold Spring Road, Indianapolis, IN 46222 USA.