Why wait: early enteral feeding after pediatric gastrostomy tube placement

Amanda R. Jensen, Elizabeth Renaud, Natalie A. Drucker, Jessica Staszak, Ayla Senay, Vaibhavi Umesh, Regan F. Williams, Troy A. Markel

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Purpose: Early initiation of feedings after gastrostomy tube (GT) placement may reduce associated hospital costs, but many surgeons fear complications could result from earlier feeds. We hypothesized that, irrespective of placement method, starting feedings within the first 6 h following GT placement would not result in a greater number of post-operative complications. Methods: An IRB-approved retrospective review of all GTs placed between January 2012 and December 2014 at three academic institutions was undertaken. Data was stratified by placement method and whether the patient was initiated on feeds at less than 6 h or after. Baseline demographics, operative variables, post-operative management and complications were analyzed. Descriptive statistics were used and P-values < 0.05 were considered significant. Results: One thousand and forty-eight patients met inclusion criteria. GTs were inserted endoscopically (48.9%), laparoscopically (44.9%), or via an open approach (6.2%). Demographics were similar in early and late fed groups. When controlling for method of placement, those patients who were fed within the first 6 h after gastrostomy placement had shorter lengths of stay compared to those fed greater than 6 h after placement (P < 0.05). Total post-operative outcomes were equivalent between feeding groups for all methods of placement (laparoscopic (P = 0.87), PEG (P = 0.94), open (P = 0.81)). Conclusions: Early initiation of feedings following GT placement was not associated with an increase in complications. Feeds initiated earlier may shorten hospital stays and decrease overall hospital costs. Type of study: Multi-institutional retrospective. Level of evidence: III

Original languageEnglish
Pages (from-to)656-660
Number of pages5
JournalJournal of Pediatric Surgery
Volume53
Issue number4
DOIs
StatePublished - Apr 2018

Keywords

  • Early feedings
  • Gastrostomy tube placement
  • Outcomes
  • Pediatric

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