Endoscopic gastrostomy placement in the child with gastroesophageal reflux: is concomitant antireflux surgery indicated?

Wilson, Guin J.P.; Zee, David C. van der; Bax, N. M. A.

doi:10.1016/j.jpedsurg.2006.04.021

Cited by 39 publications

(36 citation statements)

References 24 publications

(37 reference statements)

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“…The study further described poor correlation between clinical signs of GER and pH monitoring findings. These results are consistent with other reports suggesting that PEG does not appear to precipitate GERD [36,37]. Interestingly, recent data have also raised a concern regarding the association between a preoperative history of dysphagia or aspiration on modified barium swallow study and GERD, with 10.6% and 11.2%, respectively, of these patients requiring fundoplication after PEG [8•].…”

Section: Gastroesophageal Reflux Diseasesupporting

confidence: 91%

“…Sulaeman et al [9] showed that among 22 patients with normal preoperative 24-hour pH monitoring, only one later required Nissen fundoplication, compared to 7 of 24 with abnormal pH before PEG. In contrast, in a series of 28 patients with an abnormal pregastrostomy pH study, the majority of subjects with symptomatic GERD (19 of 25 patients) improved after PEG alone, which raises questions about the need for preoperative pH testing and the need for concomitant antireflux surgery [37].…”

Section: Gastroesophageal Reflux Diseasementioning

confidence: 92%

“…Increased GER is commonly seen in patients with NI [39]. The evidence regarding an increase in GER in children with NI after PEG is mixed: the clinical severity of reflux was shown to increase in some studies, but not in others [26,37,40,41]. However, there seems to be agreement that concomitant antireflux surgery should not automatically be performed in these patients, and that routine investigation for GER in asymptomatic children should be avoided [41].…”

Section: Gastroesophageal Reflux Diseasementioning

confidence: 99%

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Outcomes of Percutaneous Endoscopic Gastrostomy in Children

Fortunato

Cuffari

2011

Curr Gastroenterol Rep

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Percutaneous endoscopic gastrostomy (PEG) is a relatively safe and minimally invasive surgical method for providing enteral access in children. In pediatrics, the indications for PEG placement frequently include malnutrition or failure to thrive, as well as oropharyngeal dysphagia, especially in children with neurological impairment (NI). The risk for postoperative complications is low. However, among children with NI, gastroesophageal reflux disease (GERD) may necessitate fundoplication prior to gastrostomy tube placement. Preoperative pH probe testing has not been shown to be an effective screening tool prior to PEG placement among patients with GERD. Laparoscopic gastrostomy tube insertion was introduced in pediatric patients in an attempt to decrease complications associated with PEG. Although outcomes were reported to be similar to or better than PEG alone, future comparative studies are needed to better define the optimal patient demographic for this technique.

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Section: Gastroesophageal Reflux Diseasesupporting

confidence: 91%

Section: Gastroesophageal Reflux Diseasementioning

confidence: 92%

Section: Gastroesophageal Reflux Diseasementioning

confidence: 99%

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Outcomes of Percutaneous Endoscopic Gastrostomy in Children

Fortunato

Cuffari

2011

Curr Gastroenterol Rep

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“…It is known that the frequency of GER is increased in patients with neurological diseases (14). Some studies have supported the view that the severity of GER increases after PEG in these patients and some others have reported the opposite (15)(16)(17). However, Puntis et al (17) recommended that simultaneous antireflux operation should not be performed in these patients and investigations for GER should be avoided in patients without complaints.…”

Section: Discussionmentioning

confidence: 99%

“…Anti-reflux operation was performed in only one of our patients because of recurrent aspiration pneumonia after PEG. In patients who need placement of gastrostomy tube because of any reason, gastrostomy can be performed with the PEG method which is a simple invasive method without invasive investigation and invasive surgery and detailed examination and invasive surgery can be performed subsequently (15).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous endoscopic gastrostomy in children: a single center experience

Koca¹,

Sivrice²,

Dereci³

et al. 2015

Turk Pediatri Ars

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Aim: The aim of this study was to evaluate the demographic data and complication rates in children who had undergone percutaneous endoscopic gastrostomy in a three-year period in our Division of Pediatric Gastroenterology and to interrogate parental satisfaction. Material and Methods:The demographic data, complications and follow-up findings of the patients who had undergone percutaneous endoscopic gastrostomy between March 2011 and March 2014 were examined retrospectively using medical files. Results: Forty seven percutaneous endoscopic gastrostomy and percutaneous endoscopic gastrostomy related procedures were performed in 34 children during a three-year period. The median age of the patients was 2.25 years (3 months-16 years, first and third quartiles=1.0-6.0) and the mean body weight was 13.07±8.6 kg (3 kg-47 kg). Before percutaneous endoscopic gastrostomy procedure, the mean weight z score was -2.26±1.2 (-5-0) and the mean height z score was -2.25±0.96 (-3.85-0.98). The follow-up mean height and weight Z scores at the 12 th month after the percutaneous endoscopic gastrostomy procedure could be reached in 24 patients. A significant increase in the mean weight Z score from -2.41 to -1,07 (p=0.000) and in the mean height Z score from -2.29 to -1.99 (p=0.000) was found one year after percutaneous endoscopic gastrostomy catheter was placed in these 24 patients. Patients with neurological and metabolic diseases constituted the majority (64.7% and 26.5% respectively). Peritoneal leakage of food was detected in one patient and local stoma infections were detected in three patients after the procedure. During the follow up period, "Buried bumper syndrome" was observed in one patient. Following percutaneous endoscopic gastrostomy, the number of patients using anti-reflux medication increased from 16 (47.1%) to 18 (52.9%) (p=0.62). One patient with cerebral palsy who had aspiration pneumonia after percutaneous endoscopic gastrostomy insertion had undergone Nissen fundoplication. Percutaneous endoscopic gastrostomy tube was removed in a patient. The parents had positive views related with percutaneous endoscopic gastrostomy after the procedure. Conclusions: Percutaneous endoscopic gastrostomy is a substantially successful and reliable method in infants as well as in children and adolescents. The parents had positive views related with percutaneous endoscopic gastrostomy after the procedure. (Turk Pediatri Ars 2015; 50: 211-6)

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To Fundo or Not to Fundo?

Rangel¹

2013

JAMA Pediatr

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Endoscopic gastrostomy placement in the child with gastroesophageal reflux: is concomitant antireflux surgery indicated?

Cited by 39 publications

References 24 publications

Outcomes of Percutaneous Endoscopic Gastrostomy in Children

Outcomes of Percutaneous Endoscopic Gastrostomy in Children

Percutaneous endoscopic gastrostomy in children: a single center experience

To Fundo or Not to Fundo?

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