Long-term outcome of children receiving percutaneous endoscopic gastrostomy feeding

Area of Science:

• Pediatric Gastroenterology
• Surgical Nutrition
• Clinical Outcomes Research

Background:

• Percutaneous endoscopic gastrostomy (PEG) is a common procedure for enteral nutrition in children.
• Long-term data on survival, nutritional status, and complication rates in pediatric PEG patients are crucial for clinical decision-making.

Purpose of the Study:

• To analyze the long-term outcomes of pediatric patients undergoing PEG.
• To evaluate survival, nutritional status, and weaning from enteral nutrition post-PEG.
• To assess PEG-related complications and outcomes in children with neurological disabilities.

Main Methods:

• A single-center retrospective study included 368 pediatric patients who underwent PEG between 1990 and 2003.
• Data collected included survival, nutritional parameters (weight/age and height/age z-scores), PEG status (in place or removed), and complication types and timing.
• Multivariate analysis was used to identify factors associated with complications.

Main Results:

• After a median follow-up of 2.4 years, 36% of patients had PEG in place, 27% had it removed, and 26% had died. Only two deaths were directly PEG-related.
• Significant improvements in weight and height z-scores were observed in patients with PEG in place and those who were weaned.
• Early complications occurred in 152 patients and late complications in 191, with most being minor (85%). Factors associated with late complications included digestive/ENT diseases, age <1 year, and PEG use >2 years.

Conclusions:

• PEG is a safe and effective long-term solution for nutritional support in children.
• The procedure facilitates significant nutritional and growth catch-up.
• Understanding risk factors for complications can optimize patient management.