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Pediatric gastrostomy

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https://www.readbyqxmd.com/read/28505050/unsedated-in-office-transgastrostomy-esophagoscopy-tge-to-monitor-therapy-in-pediatric-esophageal-disease
#1
Caroline H T Hall, Nathalie Nguyen, Glenn T Furuta, Jeremy Prager, Emily Deboer, Robin Deterding, Calies Menard-Katcher, Kelley E Capocelli, Robert E Kramer, Joel A Friedlander
Monitoring therapy in esophageal inflammatory disorders such as eosinophilic esophagitis (EoE) and reflux esophagitis often requires frequent endoscopic evaluation. We recently reported the effective use of unsedated in office Transnasal Esophagoscopy (TNE) that significantly decreased costs and anaesthetic exposure associated with pediatric esophagoscopy in EoE. Here we report a series of pediatric patients with esophagitis with gastrostomy tubes who underwent unsedated transgastrostomy esophagoscopy (TGE) in an office setting...
May 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28469371/percutaneous-endoscopy-to-diagnose-malignancy-in-gastric-outlet-obstruction-of-excluded-stomach-after-gastric-bypass
#2
Waseem Ahmad, Joshua Rubin, Wilson Kwong
Gastric cancer in the excluded stomach after Roux-en-Y gastric bypass is a rare finding and most reported diagnoses are made via surgery. Endoscopic access to the excluded stomach is difficult, even with balloon-assisted enteroscopy. We present the case of a 74-year-old woman with malignant gastric outlet obstruction of the excluded stomach, 41 years after Roux-en-Y gastric bypass. Minimally invasive access to the excluded stomach was obtained by placement of a percutaneous gastrostomy tube, followed by insertion of a pediatric gastroscope through the gastrostomy tube tract...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28424983/the-effect-of-gastrostomy-placement-on-gastric-function-in-children-a-prospective-cohort-study
#3
Josephine Franken, Femke A Mauritz, Rebecca K Stellato, David C Van der Zee, Maud Y A Van Herwaarden-Lindeboom
BACKGROUND: A gastrostomy placement is frequently performed in pediatric patients who require long-term enteral tube feeding. Unfortunately, postoperative complications such as leakage, feeding intolerance, and gastroesophageal reflux frequently occur. These complications may be due to postoperative gastric dysmotility. Our aim was to evaluate the effect of gastrostomy placement on gastric emptying in children. METHODS: A prospective study was performed including 50 children undergoing laparoscopic gastrostomy...
April 19, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28401054/single-center-experience-with-gastrostomy-insertion-in-pediatric-patients-a-10-year-review
#4
Jiyoung Kim, Hong Koh, Eun Young Chang, Sun Yeong Park, Seung Kim
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...
March 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28350680/airway-and-feeding-outcomes-of-mandibular-distraction-tongue-lip-adhesion-and-conservative-management-in-pierre-robin-sequence-a-prospective-study
#5
Ibrahim Khansa, Courtney Hall, Lauren L Madhoun, Mark Splaingard, Adriane Baylis, Richard E Kirschner, Gregory D Pearson
BACKGROUND: Pierre Robin sequence is characterized by mandibular retrognathia and glossoptosis resulting in airway obstruction and feeding difficulties. When conservative management fails, mandibular distraction osteogenesis or tongue-lip adhesion may be required to avoid tracheostomy. The authors' goal was to prospectively evaluate the airway and feeding outcomes of their comprehensive approach to Pierre Robin sequence, which includes conservative management, mandibular distraction osteogenesis, and tongue-lip adhesion...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28344917/fatal-complications-after-pediatric-surgical-interventions-lessons-learned
#6
Willemijn M Klein, Mayke E Van der Putten, Benno Kusters, Bas H Verhoeven
Placement of catheters, drains, shunts, and tubes in children can lead to serious or even fatal complications at the moment of placement, such as hemorrhage at insertion, or in the longterm, such as infections and migration into adjacent organs. The clinician should always be aware of these potential complications, especially if the child is unwell. For postmortem diagnostic evaluation, either with a computed tomography scan or an invasive autopsy, all tubes, drains, shunts, and/or catheters should be left in situ...
January 2017: European Journal of Pediatric Surgery Reports
https://www.readbyqxmd.com/read/28252524/development-and-prospective-validation-of-tools-to-accurately-identify-neurosurgical-and-critical-care-events-in-children-with-traumatic-brain-injury
#7
Tellen D Bennett, Peter E DeWitt, Rebecca R Dixon, Cory Kartchner, Yamila Sierra, Diane Ladell, Rajendu Srivastava, Jay Riva-Cambrin, Allison Kempe, Desmond K Runyan, Heather T Keenan, J Michael Dean
OBJECTIVE: To develop and validate case definitions (computable phenotypes) to accurately identify neurosurgical and critical care events in children with traumatic brain injury. DESIGN: Prospective observational cohort study, May 2013 to September 2015. SETTING: Two large U.S. children's hospitals with level 1 Pediatric Trauma Centers. PATIENTS: One hundred seventy-four children less than 18 years old admitted to an ICU after traumatic brain injury...
May 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28166998/isolated-tracheoesophageal-fistula-versus-esophageal-atresia-early-morbidity-and-short-term-outcome-a-single-institution-series
#8
R B Tröbs, W Finke, M Bahr, C Roll, M Nissen, M R Vahdad, G Cernaianu
PURPOSE: We compared the postnatal course, morbidity and early results after repair for cases of isolated or "pure" TEF with those for cases of esophageal atresia (EA) with distal tracheoesophageal fistula (TEF). METHODS: Twenty-four consecutive infants were divided into two groups: isolated TEF [TEF group] (n = 5) and EA with distal TEF [EA group] (n = 19). RESULTS: A high rate of prematurity (29%) and major cardiac and other surgically-relevant malformations (0...
March 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28159744/effectiveness-of-fundoplication-or-gastrojejunal-feeding-in-children-with-neurologic-impairment
#9
Bryan Stone, Gabrielle Hester, Daniel Jackson, Troy Richardson, Matt Hall, Ramkiran Gouripeddi, Ryan Butcher, Ron Keren, Rajendu Srivastava
BACKGROUND AND OBJECTIVES: Gastroesophageal reflux (GER), aspiration, and secondary complications lead to morbidity and mortality in children with neurologic impairment (NI), dysphagia, and gastrostomy feeding. Fundoplication and gastrojejunal (GJ) feeding can reduce risk. We compared GJ to fundoplication using first-year postprocedure reflux-related hospitalization (RRH) rates. METHODS: We identified children with NI, dysphagia requiring gastrostomy tube feeding and GER undergoing initial GJ placement or fundoplication from January 1, 2007 to December 31, 2012...
March 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28109495/swallowing-function-in-pediatric-patients-with-bilateral-vocal-fold-immobility
#10
Jeffrey Hsu, Kathleen M Tibbetts, Derek Wu, Michel Nassar, Melin Tan
INTRODUCTION: Infants with bilateral vocal fold immobility (BVFI) often have poor swallow function in addition to potential airway compromise. While there are several reports on BVFI and its effect on patients' airway status, little is known about long term swallow function. OBJECTIVES: We aim to characterize the swallowing function over time in pediatric patients with bilateral vocal fold immobility. METHODS: A retrospective review of medical records of infants diagnosed with BVFI at a tertiary care children's hospital between 2005 and 2014 was conducted...
February 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28107287/case-volume-and-revisits-in-children-undergoing-gastrostomy-tube-placement
#11
Marjorie J Arca, Shawn J Rangel, Matt Hall, David H Rothstein, Martin L Blakely, Peter C Minneci, Samir S Shah, Kurt F Heiss, Charles L Snyder, Loren Berman, Marybeth Browne, Charles D Vinocur, Mehul V Raval, Adam B Goldin
OBJECTIVE: Emergency department (ED) visits and hospital readmissions are common following gastrostomy tube (GT) placement in children. We sought to characterize inter-hospital variation in revisit rates and explore the association between this outcome and hospital-specific GT case volume. STUDY DESIGN: We conducted a retrospective cohort study from 38 hospitals using the Pediatric Health Information System (PHIS) database. Patients <18 years who had a GT placed in 2010-2012 were assessed for a GT-related (mechanical or infectious) ED visit or inpatient readmission at 30 and 90 days following discharge from GT placement...
January 20, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28039511/increased-morbidity-and-mortality-in-cardiac-patients-undergoing-fundoplication
#12
Heather L Short, Curtis Travers, Courtney McCracken, Mark L Wulkan, Matthew S Clifton, Mehul V Raval
BACKGROUND: Infants with congenital cardiac disease (CCD) often require gastrostomy tube placement (GT) and need antireflux procedures, such as fundoplications. Our purpose was to compare morbidity/mortality rates among infants with CCD undergoing GT, fundoplication, or both. METHODS: Using the NSQIP-Pediatric, we identified 4070 patients <1-year-old who underwent GT and/or fundoplication from 2012 to 2014. 2346 infants (58%) had CCD categorized as minor, major or severe...
December 30, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/28012691/multicentre-survey-on-the-current-surgical-management-of-oesophageal-atresia-in-belgium-and-luxembourg
#13
Helena Reusens, Lucas Matthyssens, Charlotte Vercauteren, Katrien van Renterghem
INTRODUCTION: The surgical management of oesophageal atresia (OA) differs between pediatric surgical teams without consensus. We aimed to describe the current practice of OA treatment in Belgium and Luxembourg and compare this to the literature. MATERIALS AND METHODS: A questionnaire was created and sent to all 18 hospitals (14 pediatric surgical units) performing OA surgery in Belgium and Luxembourg. The results were compared to the literature. RESULTS: Most units treat an average of 2-5 OA+TOF (71%) and ≤1 pure OA (pOA) per year (86%)...
February 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27942727/quantifying-the-burden-of-interhospital-cost-variation-in-pediatric-surgery-implications-for-the-prioritization-of-comparative-effectiveness-research
#14
Danielle B Cameron, Dionne A Graham, Carly E Milliren, Charity C Glass, Christina Feng, Feroze Sidhwa, Hariharan Thangarajah, Matthew Hall, Shawn J Rangel
Importance: Practice variation is believed to be a driver of excess health care spending, although few objective data exist to guide the prioritization of comparative effectiveness research (CER) in pediatric surgery. Objective: To identify high-priority general pediatric surgical procedures for CER on the basis of the following 2 complementary measures: the magnitude of interhospital cost variation as a surrogate for the need for and potential effect of CER at the patient level and the cumulative fiscal burden of this cost variation when considering the case volume from all hospitals as a surrogate for public health relevance...
February 6, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/27895228/differences-in-durability-dislodgement-and-other-complications-with-use-of-low-profile-nonballoon-gastrostomy-tubes-in-children
#15
Temara Hajjat, Riad M Rahhal
BACKGROUND: Nonballoon low-profile gastrostomy tubes (GTs) are used for enteral nutrition support in a subset of pediatric patients with feeding difficulties when use of balloon GTs is problematic. Different nonballoon low-profile tube types are available, but comparative studies are lacking. MATERIALS AND METHODS: This was a retrospective cohort study comparing complications and outcomes between different low-profile nonballoon GTs at a pediatric tertiary care center over 10 years...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27865477/tracheostomy-among-infants-with-hypoplastic-left-heart-syndrome-undergoing-cardiac-operations-a-multicenter-analysis
#16
MULTICENTER STUDY
Parthak Prodhan, Amit Agarwal, Nahed O ElHassan, Elijah H Bolin, Brandon Beam, Xiomara Garcia, Michael Gaies, Xinyu Tang
BACKGROUND: Less than 2.7% of infants undergoing congenital heart disease operations have difficulty weaning from invasive mechanical ventilation. In such instances, clinicians may choose to perform tracheostomy. Limited literature has examined tracheostomy placement specifically in infants with hypoplastic left heart syndrome (HLHS). This study evaluated the risk factors for tracheostomy placement in infants with HLHS and examined the outcomes of these infants before their first hospital discharge...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27799750/averting-the-foul-taste-of-pediatric-medicines-improves-adherence-and-can-be-lifesaving-pheburane-%C3%A2-sodium-phenylbutyrate
#17
REVIEW
Gideon Koren, Michael J Rieder, Yona Amitai
BACKGROUND: Children's aversions to poor and mostly bitter tastes and their inability to swallow tablets and capsules are major challenges in pediatric medicine. Sodium phenylbutyrate (NaPB) is a lifesaving waste nitrogen, alternative to urea nitrogen, for individuals suffering from urea cycle disorders. A major issue in the use of NaPB is its highly foul taste, which often leads to children being unable to consume it, resulting in ineffective treatment, or alternatively, necessitating the application of the drug through a nasogastric tube or gastrostomy...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27756847/optimizing-transition-to-home-enteral-nutrition-for-pediatric-patients
#18
REVIEW
Wednesday Marie A Sevilla, Barbara McElhanon
Enteral nutrition is delivered via the gastrointestinal tract when oral intake is not sufficient to maintain nutrition status. There is evidence that long-term home enteral nutrition (HEN) can be advantageous to pediatric patients by improving quality of life and function. Data from pediatric patients receiving either nasogastric tube or gastrostomy tube feeds indicate good outcomes in terms of maintaining and improving nutrition status as evidenced by anthropometric measurements. As the number of pediatric patients requiring HEN increases, development of an effective program to allow smooth transition to the home is necessary...
October 18, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27752382/airway-management-in-a-patient-with-wolf-hirschhorn-syndrome
#19
John F Gamble, Dinesh J Kurian, Andrea G Udani, Nathaniel H Greene
We present a case of a 3-month-old female with Wolf-Hirschhorn syndrome (WHS) undergoing general anesthesia for laparoscopic gastrostomy tube placement with a focus on airway management. WHS is a rare 4p microdeletion syndrome resulting in multiple congenital abnormalities, including craniofacial deformities. Microcephaly, micrognathia, and glossoptosis are common features in WHS patients and risk factors for a pediatric airway that is potentially difficult to intubate. We discuss anesthesia strategies for airway preparation and management in a WHS patient requiring general anesthesia with endotracheal intubation...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27717297/dysphagia-progression-and-feeding-skills-following-pediatric-alkali-ingestion-injury-two-case-reports
#20
Anna M Follent, Anna F Rumbach, Elizabeth C Ward, Jeanne Marshall, Pamela Dodrill, Peter Lewindon
PURPOSE: There is limited information regarding the nature of dysphagia and feeding difficulties following alkali ingestion injury to inform multidisciplinary intervention. The aim was to describe the history and nature of chronic dysphagia and feeding difficulties in two children following severe alkali ingestion injury. METHODS: Medical records, primary caregiver report, and clinical assessment were used to compile detailed case histories and assess current dysphagia and feeding skills...
October 7, 2016: Disability and Rehabilitation
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