Primary Gastrostomy Button: A Means of Long Term
Enteral Feeding in Children
RAVIT RUANGTRAKOOL, M.D., F.R.C.S.T. (Surgery), Diploma in Paediatric Surgery (London)*,
TAT HIN ONG, M.B., B.S., F.R.A.C.S.**
Affiliation : * Division of Paediatric Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University.
Bangkok 10700, Thailand.
** Department of Surgery, Royal Children's Hospital, Herston Road, Herston, Brisbane, Australia.
AbstractBetween 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 gastro-
oesophageal reflux, 2 bronchopulmonary dysplasia, 2 tumours in the neck region and 5 miscella-
neous causes. Open fundoplication concomitant with primary button, primary open button and
laparoscopic fundop1ication 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.
Keywords : Adult, Child, Stomach, Enteral Nutrition/Instrumentation, Enteral Nutrition/Adverse
Effects, Follow-up Studies, Gastrostomy, Human, Silicone Elastomers, Intubation.
Gastrointestinal
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