title: Percutaneous gastrostomy tubes in children with Pierre Robin sequence: efficacy, maintenance and complications.
abstract: BACKGROUND
  Children with Pierre Robin sequence (PRS) have significant oropharyngeal abnormalities, with respiratory and feeding difficulties. Gastrostomy tubes (G-tube) provide a means for nutrition.
  
  
  OBJECTIVE
  To evaluate the safety and efficacy of percutaneous G-tube insertion in children with PRS.
  
  
  METHODS
  Of 120 children with PRS (1996-2009), 40 were referred for G-tube insertion; clinical details were reviewed in 37/40 children (18M, 19F) at three time periods: (1) pre-G-tube insertion, (2) at G-tube insertion, (3) at G-tube removal.
  
  
  RESULTS
  Pre-G-tube: 32/37 were term infants; 5 were preterm; 16/37 children were ≤ 10th weight percentile. At G-tube insertion, mean age was 66 days, mean weight 4.4 kg (1.1-7.0 kg); 19 dropped ≥10 weight percentiles; 12 tolerated nil by mouth; 2/37 were intubated for the procedure. All G-tubes were successfully placed, with five minor technical issues. Early postprocedure, there were eight minor complications and two dislodgements (classified as major). At G-tube removal mean G-tube dwell time was 2 years, with an average of 3.6 maintenance procedures per child, approximately 3 tube changes/1,000 tube days. At G-tube removal, 76% had maintained or increased weight centiles.
  
  
  CONCLUSIONS
  G-tubes in PRS provide a safe method for nutrition until children feed adequately by mouth.
authors: Department of Diagnostic Imaging, Image-Guided Therapy, The Hospital for Sick Children, 555 University Ave., Toronto, Canada, M5G 1X8.
authors: Hyder
authors: H
authors: Al-Attar
authors: Arvind K
authors: AK
authors: Shergill
authors: Nicole E
authors: NE
authors: Brown
authors: Cindy
authors: C
authors: Guernsey
authors: David
authors: D
authors: Fisher
authors: Michael
authors: M
authors: Temple
authors: Philip
authors: P
authors: John
authors: Joao G
authors: JG
authors: Amaral
authors: Dimitri
authors: D
authors: Parra
authors: Bairbre L
authors: BL
authors: Connolly
mesh_terms: D020878:Device Removal; D004750:Enteral Nutrition / Q000009:adverse effects / Q000295:instrumentation; D001068:Feeding and Eating Disorders / Q000209:etiology* / Q000517:prevention & control*; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000295:instrumentation; D008297:Male; D010855:Pierre Robin Syndrome / Q000150:complications*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015430:Weight Gain