Primary gastrostomy button: A means of long term enteral feeding in children

Abstract

Between June 1992 and December 1997, forty-two patients (M 19, F 23) received 94 primary gastrostomy buttons due to 22 intellectual handicap, 7 cystic fibrosis, 4 severe gastrooesophageal reflux, 2 bronchopulmonary dysplasia, 2 tumours in the neck region and 5 miscellaneous causes. Open fundoplication concomitant with primary button, primary open button and laparoscopic fundoplication concomitant with primary button were performed in 20,15 and 7 patients respectively. The average longevity +,-standard deviation of all buttons was 388.36 +,-360.35 days. The average longevity of the buttons of the laparoscopic fundoplication group was significantly lower than the others. The major causes of removal of Bard buttons were valve incompetence and flap damage, whereas, balloon leakage was the major cause of removal of the Mic-key button. There were merely minor stomal complications and no gastric separation and peritonitis. Because of the acceptable longevity of the buttons and minimal complications, we concluded that the primary gastrostomy button was the preferable method of long term enteral feeding in children.