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

Pediatr Radiol. 2012 May;42(5):566-73. doi: 10.1007/s00247-011-2301-2. Epub 2011 Dec 1.

Abstract

Background: Children with Pierre Robin sequence (PRS) have significant oropharyngeal abnormalities, with respiratory and feeding difficulties. Gastrostomy tubes (G-tube) provide a means for nutrition.

Objective: To evaluate the safety and efficacy of percutaneous G-tube insertion in children with PRS.

Materials and methods: Of 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.

Results: Pre-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.

Conclusion: G-tubes in PRS provide a safe method for nutrition until children feed adequately by mouth.

MeSH terms

  • Device Removal
  • Enteral Nutrition / adverse effects
  • Enteral Nutrition / instrumentation
  • Feeding and Eating Disorders / etiology*
  • Feeding and Eating Disorders / prevention & control*
  • Female
  • Gastrostomy / adverse effects
  • Gastrostomy / instrumentation*
  • Humans
  • Infant
  • Infant, Newborn
  • Intubation, Gastrointestinal / adverse effects
  • Intubation, Gastrointestinal / instrumentation
  • Male
  • Pierre Robin Syndrome / complications*
  • Radiography, Interventional
  • Retrospective Studies
  • Weight Gain