The purpose of our study was to evaluate surgical enteric access in pediatric cancer patients to determine factors associated with postoperative complications. We performed a single-institution retrospective review of all patients below 21 years old with a primary cancer diagnosis who underwent surgical procedures for enteral access between 2004 and 2014. Multivariate logistic regression was performed to determine independent predictors of postoperative complications. During the study period, 122 patients had surgically placed feeding tubes, of whom 58% developed ≥1 complication(s) and 16% experienced a major complication. No single factor was significantly associated with developing any complication or major complication. Several trends were noted including increased complications associated with jejunostomy tubes, percutaneous endoscopic gastrostomy tubes, and abdominal radiation. Surgically placed enteric access in pediatric and adolescent cancer patients is associated with an extremely high complication rate emphasizing the importance of careful evaluation of these patients before embarking on surgical feeding access. Future work should evaluate mechanisms to decrease complications and/or explore alternative methods to provide supplemental nutrition in children and adolescents with cancer.
*Department of Pediatric Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston
Departments of †Surgical Oncology
‡Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
E.C.H. and T.C. are co-first authors.
Supported in part by the NIH/NCI under award number P30CA016672 and used by the Biostatistics Resource Group.
The authors declare no conflict of interest.
Reprints: Mary T. Austin, MD, MPH, The University of Texas MD Anderson Cancer Center, 1400 Pressler, Unit 1406, Houston, TX 77030-1439 (e-mail: MAustin@mdanderson.org).
Received May 9, 2016
Accepted June 2, 2017