• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.1
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• pp.34-40
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• 2017

Purpose: This study was performed to review the outcomes of gastrostomy insertion in children at our institute during 10 years. Methods: A retrospective chart review was performed on 236 patients who underwent gastrostomy insertion from October 2005 to March 2015. We used our algorithm to select the least invasive method for gastrostomy insertion for each patient. Long-term follow-up was performed to analyze complications related to the method of gastrostomy insertion. Results: Out of 236 patients, 120 underwent endoscopic gastrostomy, 79 had laparoscopic gastrostomy, and 37 had open gastrostomy procedures. The total major complication rates for endoscopic gastrostomy insertion, laparoscopic gastrostomy insertion, and open gastrostomy were 9.2%, 8.9%, and 8.1%, respectively. The most common major complication was gastroesophageal reflux requiring Nissen fundoplication (3.8%), and other complications included peritonitis (1.3%), hiatal hernia (1.3%), and bowel perforation (0.8%). Gastrostomy removal was successful in 8.6% and 5.0% of patients in the endoscopic and surgical gastrostomy groups, respectively. Gastrocutaneous fistula occurred in 60% of surgically inserted cases, requiring a second operation. Conclusion: This retrospective study was performed to review the outcome of gastrostomy insertion, as well as to introduce an algorithm that can be used for future cases. Further studies should be conducted to make a consensus on choosing the most appropriate method for gastrostomy insertion.

• Advances in pediatric surgery
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• v.12 no.2
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• pp.251-256
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• 2006

This case report describes a baby who received a laparoscopic gastrostomy tube insertion, which was dislodged accidentally at $16^{th}$ postoperative day. After the dislodgement, cutaneous tract rapidly closed, and reinsertion seemed to be impossible. However, gastrostomy tube was reinserted safely with fluoroscopy-guided Seldinger's technique under local anesthesia with sedation. This is the unique method of modified Seldinger's technique for reinsertion of gastrostomy tube under local anesthesia and sedation for accidentally dislodged gastrostomy tube. This method was thought to be safe, easy and useful technique for gastrostomy reinsertion after dislodgement of gastrostomy tube.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.2
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• pp.112-115
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• 2014

Feeding gastrostomy is widely used for children with feeding impairment. The replacement of gastrostomy tube is known as an easy and safe procedure. However, various complications associated with replacement of gastrostomy tube were reported, including fistula disruption and colo-cutaneous fistula. For replacement of gastrostomy tube in small children with small stomach, special cautions are needed. Here, we report a rare case of duodenal perforation as an acute complication after the replacement of gastrostomy tube for a 33-month-old girl.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.1
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• pp.31-37
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• 2008

Patients with impaired ability to eat require nutritional support enterally or parenterally. Gastrostomy is a preferred method because total parenteral nutrition has many complications and high cost. Surgical gastrostomy has been a traditional and well-established method prior to the development of percutaneous gastrostomy. Since then, percutaneous gastrostomy has been established as an effective, safe, easy technique with a low morbidity and mortality rate. Consequently, percutaneous gastrostomy has been the first method for long-term enteral nutrition. The purpose of this review is to describe the techniques, indications, complications of percutaneous radiologic gastrostomy/gastrojejunostomy and to compare with endoscopic method.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.3
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• pp.156-164
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• 2023

Purpose: This study aimed to provide an overview of the prevalence of the complications of a gastrostomy or a gastrojejunostomy with a low-profile gastric tube in children. The study also examined the effect of presence of the gastrostomy tube on the prevalence of complications. Methods: In this cross-sectional study, parents were invited to complete an online questionnaire. Children aged 0-16 years with a low-profile gastrostomy or gastrojejunostomy tube were included in the study. Results: A total of 67 complete surveys were conducted. The mean age of the included children was seven years. The most common complications during the past week, were skin irritation (35.8%), abdominal pain (34.3%), and the formation of granulation tissue (29.9%). The most common complications during the past six months were skin irritation (47.8%), vomiting (43.4%), and abdominal pain (38.8%). Most complications occurred within the first year after gastrojejunostomy placement and gradually decreased as the duration since the placement of the gastrojejunostomy tube increased. The prevalence of severe complications was rare. Parental confidence in caring for the gastrostomy positively correlated with increases in the duration of the gastrostomy tube. Even so, parental confidence in the care of the gastrostomy tube was reduced in some parents more than a year after its placement. Conclusion: The prevalence of gastrojejunostomy complications in children is relatively high. The incidences of severe complications after the placement of a gastrojejunostomy tube were rare in this study. A lack of confidence in the care of the gastrostomy tube was noted in some parents more than a year after its placement.

• Journal of the Korean Society of Radiology
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• v.16 no.5
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• pp.559-565
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• 2022

In this study, we intend to develop a granulation tissue formation model. As a pilot experiment, a contrast agent was injected into the pylorus in 3 rats, the normal pylorus lumen size was confirmed, and a stent was placed. Stent migration was confirmed in to the duodenum within 1 week. In this experiment, stent was sutured and fixed to induce granulation tissue formation after gastrostomy under a fluoroscopic guidance. Twenty rats were divided into Healthy Group / Gastrostomy Group. After anesthesia of the Gastrostomy Group, an abdominal incision was performed, and gastrostomy was performed under a fluoroscopic guidance, and a stent was placed into the pylorus. In order to prevent stent migration due to peristalsis, suture between the pylorus and the proximal end of the stent was performed. Postoperative behavior and weight changes were monitored daily. Four weeks after surgery, gastrointestinal fluoroscopy imaging was performed and rats were sacrifices. To evaluate the degree of granulation formation, the stent was sectioned transversely. Gastrostomy group was statistically significantly higher than Healthy Group in granulation area ratio (all p<.001). In conclusion, it is considered that the level of tissue overgrowth formation for preclinical evaluation of the pylorus stricture model through gastrostomy is appropriate as a research evaluation tool.

• Journal of Veterinary Clinics
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• v.32 no.1
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• pp.28-35
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• 2015

Aim of this study is demonstrate the feasibility of Laparoscopic gastrostomy (LG) tube placement in dogs by comparing with percutaneous endoscopic gastrostomy (PEG) tube placement, based on operative time, complications and gastro-peritoneal adhesion evaluation. Eight intact male beagle dogs were used in this study. Tri-Funnel Replacement Gastrostomy tube (Bard Inc., USA) of 20 Fr was used for LG technique and PEG kit (Ponsky "Pull" PEG Kit$^{(R)}$, Bard Inc., USA) with soft silicone retention dome consisting of a 20 Fr gastrostomy tube was used. Feeding via gastrostomy tube was performed in two weeks, maintenance energy requirement (MER) divided into 3 separate feeding. LG and PEG were evaluated at intraoperative, postoperative and postmortem period. Mean operative time for the PEG group was significantly shorter when compared with the LG group (p < 0.05). Successful maintenance of gastrostomy tube was confirmed in all dogs. Gastric and peritoneal wall adhesions were formed successfully in each group. The mean adhesion length (AL) and width (AW) were significantly larger in LG group compared with in PEG group (p < 0.05). The mean adhesion distance (AD) was not significantly different between two groups (p = 0.182). Consequently, LG is an effective minimally invasive, safe and easy to perform technique for providing enteral nutritional support in dogs.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.1
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• pp.27-33
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• 2017

Purpose: Gastrostomy is commonly used procedures to provide enteral nutrition support for severely handicapped patients. This study aimed to identify and compare outcomes and complications associated with percutaneous endoscopic gastrostomy (PEG) and surgical gastrostomy (SG). Methods: A retrospective chart review of 51 patients who received gastrostomy in a single tertiary hospital from January 2000 to May 2016 was performed. We analyzed the patients and the complications caused by the procedures. Results: Among the 51 patients, 26 had PEG and 25 had SG. Four cases in the SG group had fundoplication for gastroesophageal reflux disease. PEG and SG groups were followed up for an average of 29 months and 44 months. Major complications occurred in 19.2% of patients in the PEG group and 20.0% in the SG group, but significant differences between the groups were not observed. Minor complications occurred in 15.4% of patients in the PEG group and 52.0% in the SG group. Minor complications were significantly lower in the PEG group than in the SG group (p=0.006). The average use of antibiotics in the PEG and SG groups was 6.2 days and 15.7 days (p=0.002). Thirteen patients died of underlying disease but not related to gastrostomy, and only one patient died due to complications associated with general anesthesia. Conclusion: The duration of antibiotics use and incidence of minor complications were significantly lower in the PEG group than those in the SG group. Early PEG could be recommended for nutritional supports.

• Journal of Korean Neurosurgical Society
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• v.56 no.4
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• pp.361-363
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• 2014

Percutaneous endoscopic gastrostomy tube placement is often performed in patients with a ventriculoperitoneal shunt and it has been accepted as a safe procedure. The authors report a case of a 50-year-old male who developed acute exacerbation of the hydrocephalus immediately after the percutaneous endoscopic gastrostomy tube placement without any signs of shunt infection, which has not been reported until now. After revision of the intraperitoneal shunt catheter, the sizes of the intracranial ventricles were normalized.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.1
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• pp.86-89
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• 2019

Buried bumper syndrome is a rare but potentially severe complication of percutaneous endoscopic gastrostomy tube insertion. Though this complication is uncommon, it may lead to pressure necrosis, bleeding, perforation, peritonitis, sepsis, or death. Each case of buried bumper syndrome is unique in terms of patient comorbidities and anatomic positioning of the buried bumper. For this reason, many approaches have been described in the management of buried bumper syndrome. In this case report, we describe the case of an adolescent Caucasian female who developed buried bumper syndrome three years after undergoing percutaneous endoscopic gastrostomy insertion. We review diagnosis and management of buried bumper syndrome and describe a novel technique for bumper removal in which we use a guide wire in combination with external traction to maintain a patent gastrostomy lumen while removing the internal percutaneous endoscopic gastrostomy bumper.