![]() Major complications were those that required a significant medical intervention. In 2004, a study published by Friedman et al ( 2) reported an incidence of 5% for major complications and 73% for minor complications associated with G and GJ tubes. ![]() These very large numbers do not even include visits to primary care providers, the emergency department or the enterostomy nurse specialist. During that time period, there were 932 return visits for G tube-related and 793 visits for GJ tube-related complications or maintenance issues in children who had their tube placed at our hospital at some point in the past. As an example, in 2008/2009, 296 G tubes and 21 GJ tubes were inserted in the image-guided therapy (IGT) department of our hospital using the percutaneous retrograde gastrostomy (PRG) technique. Although feeding tubes are considered to be safe and effective, they are not without problems ( 1, 2, 4). GJ tubes, which are not the preferred tubes, can be considered in certain circumstances such as when medical management for gastroesophageal reflux disease has failed and/or when the risk of aspiration of stomach contents needs to be decreased. Common types of diseases in children requiring long-term feeding tubes include neurological (29%) and non-neurological syndromes (18%), cancer (15%), and gastrointestinal (13%), cardiac (10%) and metabolic diseases (6%) ( 5). Supplementation can be complete or partial depending on the child’s ability to feed safely by mouth. Gastrostomy (G) and gastrojejunostomy (GJ) tube placement has become a common intervention to enhance nutrition and hydration, and facilitate the administration of medications to children with many different underlying problems ( 1– 4).
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