Differences in Durability, Dislodgement, and Other Complications With Use of Low-Profile Nonballoon Gastrostomy Tubes in Children

Background: Nonballoon low-profile gastrostomy tubes (GTs) are used for enteral nutrition support in a subset of pediatric patients with feeding difficulties when use of balloon GTs is problematic. Different nonballoon low-profile tube types are available, but comparative studies are lacking. Materials and Methods: This was a retrospective cohort study comparing complications and outcomes between different low-profile nonballoon GTs at a pediatric tertiary care center over 10 years. Results: We identified 43 patients with 160 tube placement procedures, including 93 (58%) BARD tubes (type A) and 67 (42%) Mini-ONE tubes (type B). Accidental tube dislodgment occurred exclusively with type B (33% vs 0%, P <.0001) with dislodgment occurring at a median of 54 days after placement. Type A GTs were more likely to be changed due to leakage (47% vs 8%, P <.0001). Minor gastrostomy site bleeding was more likely to be seen with type A tube changes (46% vs 7%, P <.0001). Patient sedation or site dilation was rarely needed in either group. Time to tube change was longer in the type B GTs (BARD) (P =.016) with a median tube survival in the type A and type B groups at 432 and 284 days, respectively, with a hazard ratio of 1.89 (95% confidence interval, 1.2-2.99), but once confounders were accounted for, the effect of tube type was no longer statistically significant. Conclusion: Our study shows that differences exist with use of various low-profile nonballoon GTs. This should be taken into consideration when counseling families about the most appropriate tube type for their children.