title: Efficacy and safety of radiologically placed gastrostomy tubes in paediatric haematology/oncology patients.
abstract: BACKGROUND
  The treatment of malnutrition, which is of great concern in paediatric 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.
  
  
  METHODS
  Patient data were acquired by retrospective review of all haematology, oncology, and bone marrow transplant (BMT) patients (n = 44) who received radiologically placed 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 patients; 2 patients experienced localized peritonitis, and 1 patient developed a localized collection of pus in the abdominal wall. There were no G-tube-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, 28% maintained, and 3% lost weight. There was a statistically significant weight gain from the time of the G-tube placement to both 1 month (P < 0.018) and 3 months (P < 0.0001) after G-tube placement. Patients in all diagnosis categories showed improvement from 1 to 3 months.
  
  
  CONCLUSIONS
  We conclude that retrograde tube placement is safe and can frequently be done without general anaesthetic and that G-tube feeding effectively reverses malnutrition and prevents weight loss in this patient population.
authors.affiliation: Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada. mary.barron@sickkids.on.ca
authors.forename: M A
authors.initials: MA
authors.lastname: Barron
authors.forename: D S
authors.initials: DS
authors.lastname: Duncan
authors.forename: G J
authors.initials: GJ
authors.lastname: Green
authors.forename: D
authors.initials: D
authors.lastname: Modrusan
authors.forename: B
authors.initials: B
authors.lastname: Connolly
authors.forename: P
authors.initials: P
authors.lastname: Chait
authors.forename: E F
authors.initials: EF
authors.lastname: Saunders
authors.forename: M
authors.initials: M
authors.lastname: Greenberg
mesh_terms: D000293:Adolescent; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects* / Q000379:methods*; D019337:Hematologic Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D008499:Medical Records; D009752:Nutritional Status; D011859:Radiography; D012189:Retrospective Studies