Percutaneous Endoscopic Gastrostomy in Children

Abstract

Percutaneous endoscopic gastrostomy has been a valuable tool in nutritional rehabilitation since its inception in 1980. Although it was originally described in children, a large sector of the adult population is dependent on it for nutritional support. Percutaneous endoscopic gastrostomy tube insertion is generally a safe procedure. Nevertheless, variable incidence rates of complications have been reported. The present review highlights the up-to-date indications, contraindications and complications of percutaneous endoscopic gastrostomy in children, along with a discussion of issues that need further exploring through future research.

Laparoscopic-assisted percutaneous endoscopic gastrostomy: insertion of a skin-level device using a tear-away sheath

“…G astrostomy tube insertion in children can be performed via open surgery, percutaneous endoscopic gastrostomy (PEG), laparoscopic gastrostomy, or percutaneous radiologic gastrostomy. [1][2][3][4][5] Percutaneous endoscopic gastrostomy insertion remains popular in many centres because it can be performed quickly and does not require incisions. 1,2 This approach provides visualization of the stomach but not the peritoneal cavity, which can lead to injuries to the colon, small bowel, liver and spleen.…”

Antioxidant intake in paediatric oncology patients

“…high density). El-Mantary, (45) suggested that aggressive nutritional support was essential in improving the outcome in cancer patients in catabolic states. However, it is often difficult to establish adequate oral feeding despite energy dense supplements due to the underlying malignancy, in addition to the aggressive chemo-and radiotherapy.…”

“…Nasogastric and nasojejunal tubes were most frequently used for shorter term feeding whereas gastrostomy and jejunostomy feeding were suggested for longer term feeding and certain cancers in which high dose treatment was frequent and associated with vomiting. (45) Parenteral nutrition is reserved for those children whose enteral feeding regimens cannot provide adequate nutrition, in particular children with abnormal gastrointestinal function that is related either to the tumour or a side effect of treatment. (1,46) In comparison to parenteral feeding, enteral nutrition is considered to be more practical, has a lower risk of infection, maintains gut integrity and reduces the risk of bacterial translocation.…”

“…(12) From the findings of this study it would seem pertinent that detailed dietary analysis and early supportive nutrition is needed in cancer treatment. According to a review by El-Mantary, (45) aggressive nutritional rehabilitation is very important in improving the outcome in cancer children in catabolic states. With an underlying malignancy, in addition to the aggressive chemo-and radiotherapy, it is not uncommon to have difficulty in establishing adequate nutrition via the oral route.…”

“…With an underlying malignancy, in addition to the aggressive chemo-and radiotherapy, it is not uncommon to have difficulty in establishing adequate nutrition via the oral route. (45) In particular cancer groups it was found that early aggressive nutritional support was needed to improve outcome. This was clearly indicated in an publication by Ward et al about early initiation of PEG feeding in children with Medulloblastomas (Solid tumours).…”