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

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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.

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Authors and Affiliations

  1. Department of Diagnostic Imaging, Image-Guided Therapy, The Hospital for Sick Children, 555 University Ave., Toronto, Canada, M5G 1X8

    Hyder Al-Attar, Arvind K. Shergill, Nicole E. Brown, Michael Temple, Philip John, Joao G. Amaral, Dimitri Parra & Bairbre L. Connolly

  2. University of Western Ontario, London, Canada

    Hyder Al-Attar

  3. Cleft Lip and Palate Program, The Hospital for Sick Children, Toronto, Canada

    Cindy Guernsey & David Fisher

Authors
  1. Hyder Al-Attar
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  2. Arvind K. Shergill
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  3. Nicole E. Brown
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  4. Cindy Guernsey
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  5. David Fisher
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  6. Michael Temple
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  7. Philip John
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  8. Joao G. Amaral
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  9. Dimitri Parra
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  10. Bairbre L. Connolly
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Corresponding author

Correspondence to Bairbre L. Connolly.

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Al-Attar, H., Shergill, A.K., Brown, N.E. et al. Percutaneous gastrostomy tubes in children with Pierre Robin sequence: efficacy, maintenance and complications. Pediatr Radiol 42, 566–573 (2012). https://doi.org/10.1007/s00247-011-2301-2

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  • DOI: https://doi.org/10.1007/s00247-011-2301-2

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