title: Differences in Durability, Dislodgement, and Other Complications With Use of Low-Profile Nonballoon Gastrostomy Tubes in Children.
abstract: BACKGROUND
  Nonballoon low-profile gastrostomy tubes (GTs) are used for enteral nutrition support in a subset of pediatric patients with feeding difficulties when use of balloon GTs is problematic. Different nonballoon low-profile tube types are available, but comparative studies are lacking.
  
  
  METHODS
  This was a retrospective cohort study comparing complications and outcomes between different low-profile nonballoon GTs at a pediatric tertiary care center over 10 years.
  
  
  RESULTS
  We identified 43 patients with 160 tube placement procedures, including 93 (58%) BARD tubes (type A) and 67 (42%) Mini-ONE tubes (type B). Accidental tube dislodgment occurred exclusively with type B (33% vs 0%, P < .0001) with dislodgment occurring at a median of 54 days after placement. Type A GTs were more likely to be changed due to leakage (47% vs 8%, P < .0001). Minor gastrostomy site bleeding was more likely to be seen with type A tube changes (46% vs 7%, P < .0001). Patient sedation or site dilation was rarely needed in either group. Time to tube change was longer in the type B GTs (BARD) ( P = .016) with a median tube survival in the type A and type B groups at 432 and 284 days, respectively, with a hazard ratio of 1.89 (95% confidence interval, 1.2-2.99), but once confounders were accounted for, the effect of tube type was no longer statistically significant.
  
  
  CONCLUSIONS
  Our study shows that differences exist with use of various low-profile nonballoon GTs. This should be taken into consideration when counseling families about the most appropriate tube type for their children.
authors.affiliation: 1 Division of Pediatric Gastroenterology, Connecticut Children's Medical Center, Hartford, Connecticut, USA.
authors.forename: Temara
authors.initials: T
authors.lastname: Hajjat
authors.affiliation: 2 Division of Pediatric Gastroenterology, Department of Pediatrics, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Riad M
authors.initials: RM
authors.lastname: Rahhal
mesh_terms: D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition; D005260:Female; D005774:Gastrostomy / Q000295:instrumentation*; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D012189:Retrospective Studies
keywords: complications; enteral nutrition; gastrostomy tube; pediatrics; tube feeding