Percutaneous endoscopic gastrostomy in children: a single center experience

Abstract

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)

Percutaneous Endoscopic Gastrostomy Tubes Can Be Considered Safe in Children: A Single-Center 11-Year Retrospective Analysis

“…The median age of the patients included in our study was 110 months, which is higher than in previously published articles [7,17,21,22]. The most common underlying disease as the main indication for PEG insertion in our research is CNS disease, which is in correlation with other larger studies [18,21,22].…”

Percutaneous endoscopic gastrostomy in children

“…In a study by Tugba-Koca et al, 8 the number of children who used anti-reflux medications increased from 16 (47.1%) to 18 (52.9%) after insertion of a PEG tube. We also observed an increase in the use of anti-reflux medications after placement of PEG tube from 19 (48.7%) to 21 (51.2%) children.…”

“…In general, major complications are rare, while minor complications are proportionally expected. 8 In a study carried out by Fortunato et al 16 on 760 children with a PEG tube, local infection happened in 8% of the children and granulation tissue happened in 9% of children. In our study, the most common complication was local infection (n=12, 30.7%) followed by granulation tissue (n=6, 15.4%).…”

“…Percutaneous endoscopic gastrostomy insertion is an endoscopic technique that allows the insertion a tube to create a tunnel between the abdominal wall and the stomach, facilitating passing of medication, fluid, and food into the patient’s stomach. 8 There are a few reports in infants with PEG tubes insertion. 9 The appropriate body weight for insertion of PEG in the previous guidelines was approximately 10 kg.…”

“…This is compatible with study carried out by Srinivasan et al, 13 it was reported that 160 (41.6%) of 384 subjects in whom PEG was placed had neurological problems and 7 (1.8%) had metabolic problems. In a study by Tugba-Koca et al, 8 the number of children who used anti-reflux medications increased from 16 (47.1%) to 18 (52.9%) after insertion of a PEG tube. We also observed an increase in the use of anti-reflux medications after placement of PEG tube from 19 (48.7%) to 21 (51.2%) children.…”