title: Trends in the use of gastrostomies at a tertiary paediatric referral centre.
abstract: OBJECTIVE
  The aims of this study were to describe the population of paediatric patients undergoing gastrostomy placement at a Norwegian tertiary referral centre and to investigate trends over time in patient characteristics and operative technique.
  
  
  METHODS
  Patients <15 years of age getting a primary gastrostomy from 1994 to 2012 were included in this retrospective observational study. Patient data were collected from medical records and the National Registry.
  
  
  RESULTS
  Six-hundred forty-nine patients with a median age of 1.2 years [gestational week 30-14.9 years] were included. Neurological disorders (ND) was the most common underlying group of diagnosis (n = 311, 48%), followed by cardiac disease 104 (16%), congenital anomalies 85 (13%), respiratory disease 43 (7%), malignancy 29 (5%), and others 77 (12%). At follow-up, 162 (25%) patients were dead. A percutaneous endoscopic technique (PEG) was used in 401 (62%) patients, open surgery (OPEN) in 201 (31%) and laparoscopy (LAP) in 47 (7%). The number of gastrostomies per year more than doubled during the period (p < 0.001). More patients with cardiac disease and congenital anomalies were given a gastrostomy during the last years (all p < 0.05), whereas the number of patients with ND remained stable. Furthermore, there has been a decrease in median age and an increase in the number of PEG and LAP (p < 0.05).
  
  
  CONCLUSIONS
  The number of gastrostomy insertions has increased from 1994 to 2012. NDs is the most common underlying diagnosis in patients receiving a gastrostomy, PEG is the most common technique and patient characteristics have changed during the study period.
authors.affiliation: a Institute of Clinical Medicine, University of Oslo , Oslo , Norway ;|b Department of Gastrointestinal and Paediatric Surgery , Oslo University Hospital, Rikshospitalet , Norway ;
authors.forename: Morten
authors.initials: M
authors.lastname: Kvello
authors.affiliation: a Institute of Clinical Medicine, University of Oslo , Oslo , Norway ;|b Department of Gastrointestinal and Paediatric Surgery , Oslo University Hospital, Rikshospitalet , Norway ;
authors.forename: Tone Lise
authors.initials: TL
authors.lastname: Åvitsland
authors.affiliation: a Institute of Clinical Medicine, University of Oslo , Oslo , Norway ;|b Department of Gastrointestinal and Paediatric Surgery , Oslo University Hospital, Rikshospitalet , Norway ;
authors.forename: Charlotte Kristensen
authors.initials: CK
authors.lastname: Knatten
authors.affiliation: c Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital , Oslo , Norway ;
authors.forename: Are Hugo
authors.initials: AH
authors.lastname: Pripp
authors.affiliation: a Institute of Clinical Medicine, University of Oslo , Oslo , Norway ;|d Department of Gastroenterology , Oslo University Hospital, Rikshospitalet , Norway.
authors.forename: Lars
authors.initials: L
authors.lastname: Aabakken
authors.affiliation: a Institute of Clinical Medicine, University of Oslo , Oslo , Norway ;|b Department of Gastrointestinal and Paediatric Surgery , Oslo University Hospital, Rikshospitalet , Norway ;
authors.forename: Ragnhild
authors.initials: R
authors.lastname: Emblem
authors.affiliation: a Institute of Clinical Medicine, University of Oslo , Oslo , Norway ;|b Department of Gastrointestinal and Paediatric Surgery , Oslo University Hospital, Rikshospitalet , Norway ;
authors.forename: Kristin
authors.initials: K
authors.lastname: Bjørnland
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016099:Endoscopy, Gastrointestinal; D004750:Enteral Nutrition / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005774:Gastrostomy / Q000639:trends*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D013997:Time Factors
keywords: Enteral nutrition; PEG; gastrostomy; trends