COMPLICATIONS AND EFFECTIVENESS OF GASTROSTOMY FEEDINGS IN PEDIATRIC CANCER-PATIENTS

Purpose: The objective of this study was to assess the complications a nd efficacy of gastrostomy (GT) feedings in pediatric cancer patients. Patients and Methods: We reviewed the medical records of 33 pediatric cancer patients who received enteral nutrition via a GT. Results: Med ian age was 9.4 years (range, 1-19.8 years), and 28 of the 33 patients had solid tumors. Seventeen patients had a significant weight loss (m edian, 8.5%) and therapy-related weight loss was anticipated in 16 pat ients. The GT device was placed an average of 5.5 months after diagnos is. Twenty-five patients were fed via a tube and eight via a button de vice. The tube was placed surgically in 21 cases (including all eight button types) and endoscopically in 12. Nutritional support lasted a m edian of 9.5 months. One or more complications occurred in 30 patients and were categorized as (a) insertion site reactions (inflammation, 2 3; infection/colonization, 14; exuberant granulation tissue, 6); (b) m echanical problems (leaking, 3; obstruction, 2; breakage, 1; accidenta l dislodgement, 2); (c) insertion site bleeding, 8; and (d) feeding in tolerance, 12. Only one insertion site cellulitis progressed to a syst emic infection. All eight patients with a button GT experienced insert ion site complications, with local infection occurring significantly m ore often in patients with the button than in those with the tube GT. There were no significant associations between insertion technique and type of complication. Twenty-seven patients (82%) achieved or maintai ned ideal body weight with this intervention. Conclusions: GT feeding was associated with minor complications, but permitted effective nutri tional support for pediatric cancer patients.