University of California-Davis, Department of Surgery, Sacramento, CA, USA.
University of California-Davis, Department of Surgery, Sacramento, CA, USA.
J Pediatr Surg. 2022 Mar;57(3):532-537. doi: 10.1016/j.jpedsurg.2021.06.001. Epub 2021 Jun 11.
Identifying pediatric patients who may benefit from gastrostomy tube (GT) placement can be challenging. We hypothesized that many GTs would no longer be in use after 6 months.
Inpatient GT placements in patients < 18 years old at a tertiary children's hospital from 9/2014 to 2/2020 were included. The primary outcome was GT use <6 months (short-term). Secondary outcomes included age at placement, indication for GT, and operations for GT-related issues.
Fifteen percent (22/142) of GTs were used for <6 months post-operatively. The median duration of short-term GT use was 1.6 months (IQR 0.9-3.4 months). Short-term GTs were more likely to be placed in patients with traumatic brain injury (TBI) (18.2% vs. 4.2%, p = 0.03) and adolescents (≥12 years old, 22.7% vs. 4.0%, p = 0.005). Gastrocutaneous fistula closure was required in 33.3% of short-term patients who had their GTs removed (n = 6/18), with median total hospital charges of $29,989 per patient.
Fifteen percent of pediatric GTs placed as inpatients were used for <6 months, more commonly among adolescents and in TBI patients. One-third of patients with short-term GTs required gastrocutaneous fistula closure. Adolescents and TBI patients may benefit from consideration of short-term nasogastric tube (NGT) feeds rather than surgical GT placement.
III.
确定可能需要胃造口管（GT）放置的儿科患者可能具有挑战性。我们假设，许多 GT 在 6 个月后将不再使用。
本研究纳入了 2014 年 9 月至 2020 年 2 月在一家三级儿童医院接受住院 GT 放置的<18 岁患者。主要结局是 GT 在术后<6 个月内使用（短期）。次要结局包括 GT 放置时的年龄、GT 适应证以及与 GT 相关问题的手术。
15%（22/142）的 GT 在术后<6 个月内使用。短期 GT 使用的中位时间为 1.6 个月（IQR 0.9-3.4 个月）。短期 GT 更可能用于创伤性脑损伤（TBI）患者（18.2%比 4.2%，p=0.03）和青少年（≥12 岁）（22.7%比 4.0%，p=0.005）。有 18 例短期 GT 患者（33.3%）需要关闭胃皮瘘，他们的 GT 被移除（n=6/18），每位患者的总住院费用中位数为 29989 美元。
15%的住院放置的儿科 GT 在<6 个月内使用，在青少年和 TBI 患者中更为常见。三分之一的短期 GT 患者需要关闭胃皮瘘。青少年和 TBI 患者可能受益于考虑短期鼻胃管（NGT）喂养，而不是手术 GT 放置。
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