How many tests does it take? Minimizing preoperative testing prior to surgical placement of gastrostomy tubes in children

Background Gastrostomy tubes (GTs) provide life‐saving enteral access for children. Although upper gastrointestinal (UGI) series and impedance studies (ISs) detect gastroesophageal reflux disease (GERD) or malrotation, their benefit for preoperative evaluation of asymptomatic patients requiring GT p...

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Published in:Nutrition in clinical practice 2023-04, Vol.38 (2), p.434-441
Main Authors: Tindal, Elizabeth W., Willis, Margaret, Recinos Soto, Aldo, Coyle, Mara G., Herzlinger, Michael, Luks, Francois I., Renaud, Elizabeth J.
Format: Article
Language:English
Subjects:
Child
children
Enteral Nutrition
Fundoplication
Gastroesophageal Reflux - diagnosis
Gastroesophageal Reflux - surgery
Gastrostomy
gastrostomy tube
Humans
Infant
pediatrics
Retrospective Studies
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Summary:Background Gastrostomy tubes (GTs) provide life‐saving enteral access for children. Although upper gastrointestinal (UGI) series and impedance studies (ISs) detect gastroesophageal reflux disease (GERD) or malrotation, their benefit for preoperative evaluation of asymptomatic patients requiring GT placement is controversial. This study investigated the value of routine preoperative testing and whether specific patient characteristics could guide the selective use of these studies. Methods The charts of children who underwent GT placement from 2003 to 2019 were reviewed retrospectively. Demographics, preoperative evaluation, and postoperative course were evaluated. Results Three hundred forty‐three patients underwent GT placement, 61% with preoperative testing. Seven of 190 UGI (4%) series demonstrated malrotation, and 39 of 141 (28%) ISs revealed severe GERD. Although all malrotations were surgically addressed, only 59% (23/39) of IS‐proven GERD cases prompted simultaneous fundoplication. Age
ISSN:0884-5336
1941-2452
DOI:10.1002/ncp.10949