The Effect of Gastrostomy Placement on Gastric Function in Children: a Prospective Cohort Study
Tóm tắt
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. A prospective study was performed including 50 children undergoing laparoscopic gastrostomy. Before and 3 months after gastrostomy, assessment was performed using the 13C-octanoic acid breath test, 24-h pH monitoring, and reflux symptom questionnaires. Gastric half-emptying time significantly increased from the 57th to the 79th percentile (p < 0.001) after gastrostomy (p < 0.001). Fifty percent of patients with normal preoperative gastric emptying develop delayed gastric emptying (DGE, P > 95) after gastrostomy (p = 0.01). Most patients (≥75%) with leakage and/or feeding intolerance after gastrostomy had DGE after operation. A decrease in gastric emptying was associated with an increase in esophageal acid exposure time (r = 0.375, p < 0.001). Gastrostomy placement in children causes a significant delay in gastric emptying. Postoperative DGE was associated with gastroesophageal reflux and was found in most patients with postoperative leakage and feeding intolerance. These negative physiologic effects should be taken into account when considering gastrostomy placement in children.
Tài liệu tham khảo
Sullivan PB, Juszczak E, Bachlet AM, Lambert B, Vernon-Roberts A, Grant HW (2005). Gastrostomy tube feeding in children with cerebral palsy: a prospective, longitudinal study. Dev Med Child Neurol 47(2):77–85.
Mahant S, Friedman JN, Connolly B, Goia C, Macarthur C (2009). Tube feeding and quality of life in children with severe neurological impairment. Arch Dis Child 94(9):668–673.
Franken J, Mauritz FA, Suksamanapun N, Hulsker CC, van der Zee DC, van Herwaarden-Lindeboom MY (2015). Efficacy and adverse events of laparoscopic gastrostomy placement in children: results of a large cohort study. Surg Endosc 29(6):1545–52.
Friedman JN, Ahmed S, Connolly B, Chait P, Mahant S (2004). Complications associated with image-guided gastrostomy and gastrojejunostomy tubes in children. Pediatrics 114(2):458–461.
Arnbjornsson E, Larsson LT, Lindhagen T (1999). Complications of laparoscopy-aided gastrostomies in pediatric practice. J Pediatr Surg Dec;34(12):1843–1846.
Naiditch JA, Lautz T, Barsness KA (2010). Postoperative complications in children undergoing gastrostomy tube placement. J Laparoendosc Adv Surg Tech 20(9):781–785.
Maddern GJ, Chatterton BE, Collins PJ, Horowitz M, Shearman DJ, Jamieson GG (1985). Solid and liquid gastric emptying in patients with gastro-oesophageal reflux. Br J Surg 72(5):344–347.
Collins BJ, McFarland RJ, O’Hare MM, Shaw C, Buchanan KD, Love AH (1986). Gastric emptying of a solid–liquid meal and gastro-intestinal hormone responses in patients with erosive oesophagitis. Digestion 33(2):61–68.
Wakamatsu H, Nagamachi S, Nishii R, Higaki K, Kawai K, Kamimura K (2008). Effect of percutaneous endoscopic gastrostomy on gastrointestinal motility: evaluation by gastric-emptying scintigraphy. Nucl Med Commun 29(6):562–567.
Ono H, Azuma T, Miyaji H, Ito S, Ohtaki H, Ohtani M (2003). Effects of percutaneous endoscopic gastrostomy tube placement on gastric antral motility and gastric emptying. J Gastroenterol 38(10):930–936.
Kawahara H, Tazuke Y, Soh H, Yoneda A, Fukuzawa M (2014). Does laparoscopy-aided gastrostomy placement improve or worsen gastroesophageal reflux in patients with neurological impairment? J Pediatr Surg 49(12):1742–1745.
Haans JJ, Masclee AA (2007). Review article: The diagnosis and management of gastroparesis. Aliment Pharmacol Ther 26 Suppl 2:37–46.
Eradi B, Wright J, Gibbons NJ, Blackshaw PE, Perkins AC, Wakefield J, et al. (2006). Validity of 13C octanoic acid breath test for measurement of solid meal gastric emptying time in children. J Pediatr Surg 41(12):2062–2065.
Hauser B, De Schepper J, Caveliers V, Salvatore S, Salvatoni A, Vandenplas Y (2006). Variability of the 13C-octanoic acid breath test for gastric emptying of solids in healthy children. Aliment Pharmacol Ther 23(9):1315–1319.
Van den Driessche ML, Veereman-Wauters GA, Ghoos Y (2000). Development of gastric emptying in healthy infants and children and reference values for the 13C octanoic acid breath test. Gastroenterology 118(4):A392.
Richter JE, Bradley LA, DeMeester TR, Wu WC (1992). Normal 24-hr ambulatory esophageal pH values. Influence of study center, pH electrode, age, and gender. Dig Dis Sci 37(6):849–856.
Willems M, Quartero AO, Numans ME (2001). How useful is paracetamol absorption as a marker of gastric emptying? A systematic literature study. Dig Dis Sci 46(10):2256–2262.
Srinivasan R, Irvine T, Dalzell M (2009). Indications for percutaneous endoscopic gastrostomy and procedure-related outcome. J Pediatr Gastroenterol Nutr 49(5):584–588.
Del Giudice E, Staiano A, Capano G, Romano A, Florimonte L, Miele E (1999). Gastrointestinal manifestations in children with cerebral palsy. Brain Dev 21(5):307–311.
Sullivan PB (2008). Gastrointestinal disorders in children with neurodevelopmental disabilities. Dev Disabil Res Rev 14(2):128–136.
Nguyen NQ, Fraser RJ, Bryant LK, Holloway RH (2007). Functional association between proximal and distal gastric motility during fasting and duodenal nutrient stimulation in humans. Neurogastroenterol Motil 19(8):638–645.
Noble LJ, Dalzell AM, El-Matary W (2012). The relationship between percutaneous endoscopic gastrostomy and gastro-oesophageal reflux disease in children: a systematic review. Surg Endosc 26(9):2504–2512.
Launay V, Gottrand F, Turck D, Michaud L, Ategbo S, Farriaux JP (1996). Percutaneous endoscopic gastrostomy in children: influence on gastroesophageal reflux. Pediatrics 97(5):726–728.
Sager S, Halac M, Selcuk N, Dogan I, Kabasakal L, Onsel C (2010). Temporal relationship between gastroesophageal reflux and rate of gastric emptying in children. Nucl Med Commun 31(12):1059–1062.
Estevao-Costa J, Campos M, Dias JA, Trindade E, Medina AM, Carvalho JL (2001). Delayed gastric emptying and gastroesophageal reflux: a pathophysiologic relationship. J Pediatr Gastroenterol Nutr 32(4):471–474.
Khattak IU, Kimber C, Kiely EM, Spitz L (1998). Percutaneous endoscopic gastrostomy in paediatric practice: complications and outcome. J Pediatr Surg 33(1):67–72.
Heine RG, Reddihough DS, Catto-Smith AG (1995). Gastro-oesophageal reflux and feeding problems after gastrostomy in children with severe neurological impairment. Dev Med Child Neurol 37(4):320–329.
Razeghi S, Lang T, Behrens R (2002). Influence of percutaneous endoscopic gastrostomy on gastroesophageal reflux: a prospective study in 68 children. J Pediatr Gastroenterol Nutr 35(1):27–30.
Jolley SG, Tunell WP, Hoelzer DJ, Thomas S, Smith EI (1986) Lower esophageal pressure changes with tube gastrostomy: a causative factor of gastroesophageal reflux in children? J Pediatr Surg 21(7):624–627.