Indications for percutaneous endoscopic gastrostomy and procedure-related outcome

Area of Science:

• Pediatric Gastroenterology
• Surgical Procedures
• Nutritional Support

Background:

• Percutaneous endoscopic gastrostomy (PEG) is a vital intervention for nutritional support in pediatric patients.
• Understanding the indications, complications, and outcomes of PEG procedures is crucial for optimizing patient care.

Purpose of the Study:

• To detail the indications for and practice of PEG insertion in children.
• To evaluate complications and outcomes associated with PEG procedures.
• To analyze the role of PEG in managing feeding difficulties in pediatric populations.

Main Methods:

• An observational study was conducted using prospectively collected data.
• The study period spanned five years (2002-2006).
• Data included PEG insertions, conversions to low-profile button devices (LPBD), and removals.

Main Results:

• Six hundred one PEG-related procedures were performed, including 384 insertions.
• Feeding difficulties in neurodisability (41.6%) and congenital heart disease (CHD, 30%) were primary indications for PEG insertion.
• Children with CHD required PEG support at a significantly earlier age (0.39 years) compared to those with neurodisability (3.56 years).
• Fifty-nine patients were discharged on the same day post-PEG insertion without complications.
• Half of the permanent PEG removals were in children with CHD, suggesting resolution of feeding issues.

Conclusions:

• Neurodisability and CHD are the leading indications for PEG insertion in children.
• Children with CHD necessitate earlier nutritional support via PEG compared to those with neurodisability.
• A significant proportion of PEG removals in children with CHD indicate successful resolution of feeding difficulties, highlighting the temporary nature of PEG in this cohort.