Tube Gastrostomy and Enterostomy

Abstract

Tube gastrostomy by laparotomy has been one of the important operations for pediatric patients who have serious difficulty swallowing or eating. Percutaneous endoscopic gastrostomy (PEG) procedure has been reported in 1980 by Gauderer et al. [1]. Since PEG can be performed without laparotomy and general anesthesia, its use had spread rapidly from the 1990s in Japan. In the pediatric surgery, PEG has also become an alternative method for gastrostomy placement with the development of endoscopy. More recently, laparoscopy-assisted PEG can be considered when other minimally invasive methods such as PEG are not feasible or fail.

Tube jejunostomy is applied for pediatric patients who require enteral feeding but cannot receive nutrients from stomach by anatomical reasons. Purpose is not only injection of nutrients but also drainage of intestinal fluids and stool. Types of tube jejunostomy and postoperative management are described.

The figures in this chapter are reprinted with permission from Standard Pediatric Operative Surgery (in Japanese), Medical View Co., Ltd., 2013, with the exception of occasional newly added figures that may appear.