Pediatric surgical gastrostomy revision in the modern era, patterns, and potential modifiable factors: A retrospective analysis
In brief
Three-quarters of patients needing gastrostomy revision required longer tubes
In this 111-patient retrospective study, surgeons increased gastrostomy tube length by an average of 0.7 cm in 75% of revision cases. Excessive leaking was the most common indication, while growth-related movement toward the ribs was reported in one-third. The findings point to tube length and placement as possible ways to reduce reoperations, but the study did not test prevention strategies.
- Journal
- Journal of pediatric gastroenterology and nutrition (Q1)
- Published
- 22 September 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Tayana A Jean Pierre, Steven J Staffa, Terry L Buchmiller
- PMID
- 42773812
- DOI
- 10.1002/jpn3.70591
Why clinicians should know about it
- Picked for Pediatric Surgery (paper of the day, 27 September 2026): Retrospective analysis of pediatric gastrostomy revision patterns
Abstract
OBJECTIVES: Long-term use of gastrostomy tubes (G-Tubes) presents a potential risk for surgical gastrostomy revision (SGR) with re-siting of the tract. This study describes the patterns of SGR to ascertain if this may be a potentially modifiable event. We hypothesize that gradual tract compression or migration may contribute to the need for SGR. METHODS: A retrospective review of patients who had SGR from January 2010 to January 2024 was conducted. Data collected included demographics, anthropometric measurements at SGR, diagnosis at initial gastrostomy placement (IGP), indication for SGR, G-Tube length pre- and post-SGR. Descriptive and inferential statistics were applied. RESULTS: We included 111 patients. The median age at IGP was 0.3 years (interquartile range [IQR]: 0-2 years). The median age at SGR was 5 years (IQR: [1.6, 15.7]; range: 0-36 years). Overlapping indications for SGR included: excessive leaking in 77%, gastric prolapse in 36%, and tract migration to the costal margin with somatic growth in 33%. Tract compression was contributory to SGR as the G-Tube length had to be increased by an average of 0.7 cm in 75% of cases at SGR. A higher G-Tube length at SGR was positively correlated with higher weights (r = 0.78, p < 0.0001) and older age (r = 0.68, p = 0.0001). CONCLUSION: Migration toward the costal margin over years due to growth was documented; hence, locating the gastrostomy as inferior as possible at IGP is supported. Furthermore, anticipatorily increasing the G-Tube length to prevent tract compression due to growth over the years is strongly supported as a modifiable factor to avoid reoperation.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.