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Outcomes of percutaneous endoscopic gastrostomy in children

John E Fortunato1, Carmen Cuffari

  • 1Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, The Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. jfortuna@wfubmc.edu

Current Gastroenterology Reports
|March 17, 2011
PubMed

Insights

Percutaneous endoscopic gastrostomy (PEG) offers safe enteral access for children, particularly those with neurological impairment. Laparoscopic gastrostomy shows promise, but further studies are needed to compare its effectiveness against PEG.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Minimally Invasive Procedures

Background:

  • Percutaneous endoscopic gastrostomy (PEG) is a common, safe procedure for pediatric enteral access.
  • Indications include failure to thrive and dysphagia, especially in children with neurological impairment (NI).
  • Gastroesophageal reflux disease (GERD) in NI patients may require fundoplication before gastrostomy; preoperative pH testing is ineffective for GERD screening.

Purpose of the Study:

  • To evaluate laparoscopic gastrostomy tube insertion as an alternative to PEG in pediatric patients.
  • To compare the outcomes and complication rates of laparoscopic versus PEG procedures.
  • To identify the optimal patient population for laparoscopic gastrostomy.

Main Methods:

  • Review of outcomes for laparoscopic gastrostomy tube insertion in pediatric patients.
  • Comparison of results with existing data on percutaneous endoscopic gastrostomy (PEG) procedures.
  • Analysis of complication rates and patient demographics for both techniques.

Main Results:

  • Laparoscopic gastrostomy outcomes appear similar to or better than PEG alone.
  • The risk of postoperative complications for PEG is generally low.
  • Further comparative studies are required to fully elucidate the benefits of laparoscopic gastrostomy.

Conclusions:

  • Laparoscopic gastrostomy is a viable alternative for pediatric enteral access.
  • More research is needed to establish its superiority and define its ideal patient candidates.
  • PEG remains a safe and effective method for enteral access in children.

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