One-Step Insertion of Low-Profile Gastrostomy in Pediatric XXXX vs Pull Percutaneous Endoscopic Gastrostomy: Retrospective Analysis of Outcomes.

@entity1 @entity258 @entity970
UNASSIGNED: Background: Standard care for initiation of enteral feeding in @entity1 has been pull percutaneous endoscopic gastrostomy (pull- @entity970 ). As an alternative to pull- @entity970 , a 1-step endoscopic procedure for inserting a @entity258 "button" has been developed that allows initial placement of a balloon-retained device. This report presents outcomes of metrics used to compare button placement with pull- @entity970 in a pediatric population. Methods: Data were generated from procedural experiences of surgeons on pediatric @entity1 (n = 374) with a variety of clinical indications for gastrostomy. Study population ages ranged from 6 days to 16 years, while weights were from 2-84 kg. Results: The button was successfully placed by the 1-step procedure in 98% of the respective study population, and median procedural times were 20 and 15 minutes for button and pull- @entity970 placements, respectively. Median times to first feeds were equivalent for the 1-step procedure and pull- @entity970 (6 hours), while times to first nutrition feeds were 12.5 and 10 hours, respectively. Stoma site complications within each study group were similar. Healthy stoma proportions were 65.2% and 73.2% in the 1-step procedure and pull- @entity970 groups, respectively, at first follow-up. Conclusions: Similar study outcomes between the 1-step procedure and pull- @entity970 groups suggest that the former is a feasible alternative to pull- @entity970 for initial tube placement in @entity1 . The 1-step method involves a single procedure and reduces @entity1 exposure to anesthesia, operating room time, and the potential for complications compared with a pull- @entity970 requirement for multiple procedures.
