Systematic review of gastrostomy complications and outcomes in pediatric cancer and bone marrow transplant

Abstract

Background Nutrition support is essential in children with cancer, including those undergoing bone marrow transplant (BMT), to reduce the risk of malnutrition and associated deleterious outcomes. Enteral nutrition is more commonly provided via nasogastric than gastrostomy tubes because of safety concerns with the latter in immunocompromised children. This systematic review investigated the incidence and type of complications and outcomes in pediatric cancer patients fed by gastrostomy. Methods Databases were searched for randomized and observational studies investigating the use of any gastrostomy device in children aged Results Quality of evidence varied, with five studies judged at serious risk of bias and poor quality; however, the remaining 11 were considered to range from moderate to good quality. Across studies, 54.6% of children developed one or more complications, of which 76.6% were classified as minor, 23.4% major. The most frequent complications included inflammation (52% of episodes), infection (42.1%), leakage (22.3%), and granuloma (21%). Evidence regarding infection rates in cancer/BMT patients compared with other disease states was inconclusive. Gastrostomy feeding was associated with improvement or stabilization of nutrition status in 77%–92.7% of children. Conclusion Gastrostomy feeding in this population is relatively safe and effective in stabilizing or improving nutrition status throughout treatment. Complications are frequent but mostly minor. Placement requires careful consideration of the complications, benefits, nutrition risk and status at diagnosis, and quality of life.

Publication DOI: https://doi.org/10.1002/ncp.10724
Divisions: College of Health & Life Sciences > School of Optometry > Optometry
College of Health & Life Sciences
Additional Information: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Copyright © 2021 The Authors. Nutrition in Clinical Practice published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition
Publication ISSN: 1941-2452
Last Modified: 25 Apr 2024 07:22
Date Deposited: 02 Mar 2023 15:00
Full Text Link:
Related URLs: https://aspenjo ... .1002/ncp.10724 (Publisher URL)
PURE Output Type: Review article
Published Date: 2021-12-09
Published Online Date: 2021-07-10
Accepted Date: 2021-07-01
Authors: Evans, James
Gardiner, Breeana
Green, Dan (ORCID Profile 0000-0003-1934-6725)
Gibson, Faith
O'Connor, Graeme
Lanigan, Julie

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