Efficacy and safety of radiologically placed gastrostomy tubes in paediatric haematology/oncology patients

Background. The treatment of malnutrition, which is of great concern in pae diatric haematology/oncology patients, is fraught with problems. The goals of our study were to document the complications and assess the weight gain with gastrostomy tubes (G-tubes) in this population. Procedure. Patient dat a were acquired by retrospective review of all haematology, oncology, and b one marrow transplant (BMT) patients (n = 44) who received radiologically p laced G-tubes at our institution over a 4-year period. Results. Forty-four G-tubes were placed (59% peri-BMT). At tube placement, 55% of patients were malnourished and 45% were nourished. Seventy-five percent of patients had the procedure without general anaesthetic. Localized G-tube-site infection was the most common complication (41%). Major complications occurred in 3 p atients; 2 patients experienced localized peritonitis, and 1 patient develo ped a localized collection of pus in the abdominal wall. There were no G-tu be-related deaths. At 1 month after the tube insertion, 39% of patients had gained, 54% maintained, and 7% lost weight. At 3 months, 69% had gained, 2 8% maintained, and 3% lost weight. There was a statistically significant we ight gain from the rime of the C-tube placement to both 1 month (P < 0.018) and 3 months (P < 0.0001) after G-tube placement. Patients in all diagnosi s categories showed improvement from 1 to 3 months. Conclusions. We conclud e that retrograde tube placement is safe and can frequently be done without general anaesthetic and that G-tube feeding effectively reverses malnutrit ion and prevents weight loss in this patient population. Med. Pediatr. Onco l. 34:177-182, 2000. (C) 2000 Wiley-Liss, Inc.