TITLE:
Beyond Surgery: A Critical Evaluation of Gastrostomy Use in Trisomy 21, Necessary Intervention or Overused Resource?
AUTHORS:
Karla Adney Flores Arizmendi, Karen Nataly Herrera González, Daniela García Poblano, Laura Montserrat Espinosa Méndez, Brenda Janeth Becerril Rojas, Ritha Alejandra Vázquez Díaz, Silvestre García de la Puente, Alejandra Ochoa Rodríguez Alejandra
KEYWORDS:
Trisomy 21, Gastrostomy, Complications
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.16 No.4,
July
16,
2026
ABSTRACT: Background. Trisomy 21 (T21) or Down syndrome (DS) is the most common genetic condition, with a prevalence in Mexico of one in 650 newborns. People with DS present various comorbidities that can make sucking and swallowing difficult and lead to aspiration pneumonia. Gastrostomy is a surgical procedure used to improve nutrition and reduce the risk of bronchoaspiration in children with DS, but its indications are not well established and in many cases, it is carried out without a multidisciplinary strategy. There are few reports about gastrostomy in children with DS. Objectives. To describe the most frequent indications for gastrostomy and complications related to gastrostomy, and to establish guidelines to consider before carrying out this surgical intervention. Materials and Methods. This was a retrospective, observational study of patients with DS and gastrostomy who received care in the Mexican National Institute of Pediatrics from 1 January 2013 to 31 December 2024. Results. Approximately 1600 patients with DS were seen in the study period, 800 of whom aged 0 - 7 years, with 47 receiving gastrostomy and 18 having the gastrostomy removed by the end of the study. The most frequent indication was gastroesophageal reflux disease combined with slow weight gain. There were complications in 25 patients, the most frequent of which was periostomal infection. Conclusions. Gastrostomy is an overrated procedure that is not without complications. Orofacial rehabilitation should be attempted before it is performed.