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Reply to Letter to Editor regarding: Do we really need gastrostomy in every anatomical anomaly? A comment on patient selection for pediatric gastrostomy tubes: Are we placing tubes that are not being used?

      We would like to thank Drs. Boybeyi and Soyer for their interest in our study on pediatric gastrostomy tubes [
      • Jackson J.E.
      • Theodorou C.M.
      • Vukcevich O.
      • Brown E.G.
      • Beres A.L.
      Patient selection for pediatric gastrostomy tubes: are we placing tubes that are not being used?.
      ]. Herein we provide a response to your letter. Regarding the indications for gastrostomy tube (GT) placement, we classified them into the following categories: cardiac, pulmonary, neurological, renal, gastrointestinal, genetic, anatomic, traumatic, failure to thrive, and malignancy. In the short-term GT group, the patients classified as gastrointestinal indications had meconium ileus or anorectal malformations. The patients in the short-term group with an anatomic indication both had laryngomalacia. With regards to esophageal atresia, there was one patient in the long-term group who had esophageal atresia. As you mentioned, there may be difficulty passing a nasogastric (NG) tube into the stomach for this specific population of children and therefore they may not be candidates for NG feeds. In addition, this is likely why this patient with esophageal atresia was in the long-term group, requiring use of the GT for greater than 6 months, and why there were no such patients in the short-term group.

      Abbreviations:

      GT (gastrostomy tube), NG (nasogastric)
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      References

        • Jackson J.E.
        • Theodorou C.M.
        • Vukcevich O.
        • Brown E.G.
        • Beres A.L.
        Patient selection for pediatric gastrostomy tubes: are we placing tubes that are not being used?.
        J Pediatr Surg. 2022; 57: 532-537