ABSTRACT
Gastrostomy is one of the oldest abdominal operations in continuous use and its history is closely associated with the evolution of modern surgery.
Gastrostomies are important in the management of a wide variety of surgical and non-surgical conditions of childhood. Although pediatric surgeons have become more selective in the use of gastrostomies for congenital malformations, there has been a marked increase in the use of feeding stomas in infants and children without associated surgical pathology, mainly those with an inability to swallow secondary to central nervous system disorders. This increase is reflected in the large volume of publications on the subject of the gastrostomy in the last couple of decades. Refinements in traditional procedures and the introduction of newer and simpler endoscopically, radiologically, ultrasonographically, and laparoscopically aided gastrostomies have enhanced the safety and expanded the applicability of this operation. It is perhaps fair to state that, over the years, few if any other commonly performed procedure has had as many different approaches as this seemingly simple access to the stomach. The use of softer, minimally irritating materials in the manufacture of gastrostomy catheters and the availability of several types of skin-level gastrostomy devices, commonly referred to as ‘buttons’, have greatly facilitated the long-term use of this type of enterostomy.
