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Nurse-assisted PEG in pediatric patients
1Johns Hopkins Children's Center, 600 N. Wolfe Street, Baltimore, MD 21287, USA. lwilson@jhmi.edu
Insights
Nurse-assisted percutaneous endoscopic gastrostomy (PEG) placement is safe in children. A study found no significant difference in complications between nurse-assisted and fellow-assisted PEG procedures, supporting this approach for pediatric enteral access.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Procedures
Background:
- Percutaneous endoscopic gastrostomy (PEG) is a standard method for providing enteral access in pediatric patients.
- Traditionally, PEG procedures involved surgeons and pediatric gastroenterologists, but evolving practices explore enhanced team roles.
Purpose of the Study:
- To evaluate the safety and efficacy of a nurse-assisted percutaneous endoscopic gastrostomy (PEG) program in a pediatric setting.
- To compare complication rates between nurse-assisted and gastroenterology fellow-assisted PEG procedures.
Main Methods:
- A retrospective review of 147 consecutive pediatric PEG procedures performed between June 1997 and May 1999.
- Comparison of periprocedural complications between 69 nurse-assisted PEGs and 78 gastroenterology fellow-assisted PEGs, with attending pediatric gastroenterologists as endoscopists.
Main Results:
- No statistically significant difference in the periprocedural complication rate was observed between the nurse-assisted PEG group and the gastroenterology fellow-assisted PEG group.
- This indicates comparable safety profiles for both procedural approaches.
Conclusions:
- The implementation of a nurse-assisted percutaneous endoscopic gastrostomy (PEG) program is a safe and viable option for pediatric enteral access.
- Trained endoscopy nurses can serve effectively as first assistants in pediatric PEG placements, optimizing procedural teams.
Abstract:
Percutaneous endoscopic gastrostomy (PEG) has become an accepted technique to provide enteral access in children. At the author's institution, this procedure has evolved from being performed by a surgeon and a pediatric gastroenterologist to being performed by two gastroenterologists. As studies in the adult population have shown the efficacy of training an experienced endoscopy nurse to assist with PEG placement, it was decided to develop a nurse-assisted PEG program for pediatric use and to evaluate the safety of this method. Data were collected on 147 consecutive patients undergoing PEG from June 1997 to May 1999. Sixty-nine patients had nurse-assisted PEGs, and 78 had a gastroenterology fellow-assisted PEG. Both groups had a pediatric gastroenterology attending physician as the endoscopist. The two groups were compared for periprocedure complications. No significant difference in the complication rate was found between the two groups. Our experience suggests that PEGs can be safely placed in the pediatric population using a trained endoscopy nurse as first assistant.
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