ABSTRACT
Gastrostomy is one of the oldest abdominal operations in continuous use, and its history is closely associated with the evolution of modern surgery. Gastrostomy is indicated in infants and children for long-term feeding, decompression, or a combination of both. It is also commonly employed in conjunction with other interventions, like antireflux procedures. The type of gastrostomy, preoperative workup, technique, and choice of gastrostomy device depend mainly on the reason for the procedure, the child's age and underlying disease, and the familiarity of the surgeon with the different surgical techniques. With all gastrostomy techniques, great care must be exercised in children with previous epigastric procedures, hepato- and/or splenomegaly, and in patients with severe musculoskeletal abnormalities, such as scoliosis. In general, patients who can tolerate bolus orogastric or nasogastric feeds are good candidates for gastrostomy placement alone. Gastroesophageal reflux is a common problem in neurologically impaired children both before and after the placement of a gastrostomy.
