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[Percutaneous endoscopic gastrostomy in paediatric cancer patients]
Mari Barlaug1, Aksel Kruse, Henrik Schrøder
1Arhus Universitetshospital, Skejby, Børneafdelingen.
Insights
Percutaneous endoscopic gastrostomy (PEG) effectively treats malnutrition in pediatric cancer patients, improving weight. Inflammation, often linked to neutropenia, was the most common complication.
Area of Science:
- Pediatric Oncology
- Gastroenterology
- Nutritional Support
Context:
- Malnutrition is a significant challenge in pediatric cancer patients.
- Percutaneous endoscopic gastrostomy (PEG) is a common intervention for nutritional support.
- Understanding PEG's efficacy and complications in this population is crucial.
Purpose:
- To evaluate the safety and effectiveness of PEG in treating malnutrition in children with cancer.
- To identify and quantify the complications associated with PEG placement in pediatric oncology patients.
- To analyze the impact of PEG on nutritional status (weight) in this cohort.
Summary:
- A retrospective review of 54 pediatric cancer patients who received PEG between 2000 and 2006 was conducted.
- PEG placement led to a significant increase in weight-for-age standard deviation score (SDS) from placement to removal.
- The most frequent complications were inflammation (often neutropenia-related), gastric juice leakage, and mechanical issues, with 85% of inflammations linked to neutropenia.
Impact:
- PEG is a safe and efficient method for nutritional rehabilitation in pediatric cancer patients.
- Identifying inflammation as a key complication, particularly during neutropenia, allows for targeted management strategies.
- Improved nutritional status can positively influence treatment outcomes and quality of life for these children.
Introduction:
Malnutrition is common in children with cancer. Percutaneous endoscopic gastrostomy (PEG) is a well-established method to treat malnutrition. The objective of this study was to describe the complications and efficacy of PEG in paediatric cancer patients.
Materials And Methods:
Between 1 January 2000 and 1 February 2006, 54 children in the Paediatric Oncology Unit received a PEG. Diagnosis, indications, complications and weight at the time of diagnosis, placement and removal were retrieved from a retrospective review of the medical charts.
Results:
54 children received one PEG and three children received two PEGs. Their median age was 8.9 years (10 months-15 years). The median time for PEG-use was 252 days (13-829 days). 63% of the children experienced a total of 107 complications; the most frequent being inflammation (n=48), leakage of gastric juice (n=27) and mechanical problems (n=10). Eight tubes were changed, and eight tubes were removed due to complications. 85% of the inflammations were related to neutropenia. There was a significant (p=0,0006) decrease in the median weight-for-age standard deviation score (SDS) of 0, 70 (-1,12; -0,28) from the time of diagnosis to the PEG. From the time of placement to the removal of the tube there was a significant (p=0,04) increase in the median weight-for-age SDS of 0,46 (0,02; 0,89).
Conclusion:
PEG is a safe and efficient method to treat malnutrition in paediatric cancer patients. The most frequent complication is inflammation during periods of neutropenia.
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