Percutaneous Endoscopic Gastrostomy in Children: A Population-Based Study from Iceland, 1999–2010

Abstract

PEG is a safe technique with a high complication rate, but the majority of complications are minor and easily treatable. Gastrostomy is sometimes temporary. Enteral feeding results in significant weight gain in 1 year.

Postoperative complications following percutaneous endoscopic gastrostomy are common in children

“…A high rate of complications was observed in this study (51.5%), but only 29 of 229 (12.7%) patients experienced grade 3 complications. Other studies have shown similar rates of major complications, varying from 6.6% to 10.5% . There was a difference in the time until the start of symptoms, which was a median of two months in our study compared to the six to 12 months reported by others .…”

“…One group included patients with a malignant disease and the other group included those with a neuromuscular disease, with seven of those 13 patients dying. Similar studies with different follow‐up periods reported a lower mortality rate of 5.8%–14.0% . The high mortality rate observed in children with a neuromuscular disease raises important ethical issues about the placement of a PEG tube in this group of patients.…”

“…Percutaneous endoscopic gastrostomy (PEG) is a recognised solution for long‐term enteral feeding in paediatric patients with eating problems. The most common indications are cerebral palsy and other neurological diseases , with other indications including malignancy , heart disease , renal disease , cystic fibrosis and oesophageal atresia .…”

“…The push method has been associated with a higher complication rate in adults . Prophylactic perioperative antibiotics are often administered at the location of gastrostomy tube placement, but the evidence to support their use is weak .…”

“…Minor complications after gastrostomy placement are common and are reported to vary between 16.4 and 66.3% . Major postoperative complication rates vary between 6.1 and 17.5% depending on the definition . The mean time from surgery until the appearance of major complications is typically six to 12 months, but can occur at any time .…”