Gastrostomy placement in paediatric patients with neuromuscular disorders: indications and outcome.
Studies of children with neurodevelopmental disorders have shown that receiving nutrition through a gastrostomy can improve clinical outcomes and quality of life. However, there is little information on gastrostomy and its effect in patients with neuromuscular disorders. A retrospective casenote review of all patients with a gastrostomy, followed-up at the Hammersmith Hospital, London, was undertaken to assess the indications for, and outcomes of, gastrostomy placement. Notes for 32 patients (17 males, 15 females) were reviewed (age range 32mo-31y; median age 12y 5mo). We found three main groups of diagnoses: congenital muscular dystrophy (n=15), structural congenital myopathies (n=11), and other neuromuscular disorders (n=6). Two main patterns of feeding problems were identified before gastrostomy: swallowing difficulties, and nutrition and growth problems. The follow-up period after gastrostomy was from 12 months to 19 years (mean 5y). Weight faltering was reversed in 17 out of 22 patients, and height faltering in 9 out of 14, where data were available. Twenty-six patients had a reduced frequency of chest infections. No significant complication of gastrostomy placement was documented. Twenty-eight patients or their families were happy with the results of the gastrostomy. Gastrostomy seems to have a substantial positive impact in patients with neuromuscular disease and feeding difficulties.
Ramelli
Gian Paolo
GP
Neuromuscular Unit, Department of Paediatrics and Neonatal Medicine, Imperial College, Hammersmith Hospital, London, UK.
Aloysius
Annie
A
King
Caroline
C
Davis
Trak
T
Muntoni
Francesco
F
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition; D019959:Feeding and Eating Disorders of Childhood / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy; D006801:Humans; D007223:Infant; D008297:Male; D009468:Neuromuscular Diseases / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome