Comparison of operative outcomes between surgical gastrostomy and percutaneous endoscopic gastrostomy in infants

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Medical Device Technology

Background:

• Gastrostomy tube placement is common in infants and neonates.
• The safety of surgical gastrostomy (G-tube) versus percutaneous endoscopic gastrostomy (PEG) in this population is not well-established.
• Understanding comparative safety is crucial for clinical decision-making.

Purpose of the Study:

• To compare complication and mortality rates between G-tube and PEG in infants and neonates.
• To investigate if the choice of gastrostomy procedure impacts adverse outcomes.
• To analyze safety data specifically for the neonatal subgroup.

Main Methods:

• Retrospective comparative study using the Kids' Inpatient Database.
• Identified 1456 infants who underwent either G-tube or PEG as a sole procedure.
• Analyzed variables including age, comorbidities, and severity of illness, comparing complication, reoperation, and mortality rates.

Main Results:

• No significant differences in complication rates (7.3% G-tube vs. 6.7% PEG) or mortality rates (1.3% G-tube vs. 0.7% PEG) were observed in univariate analysis.
• Adjusted analyses confirmed comparable risks for complications and mortality in both overall infants and the neonatal subgroup.
• Confidence intervals for adjusted odds ratios spanned 1, indicating no statistically significant difference.

Conclusions:

• Surgical gastrostomy and percutaneous endoscopic gastrostomy demonstrate comparable safety profiles in infants and neonates when performed as the sole procedure.
• The choice between G-tube and PEG does not appear to significantly influence postoperative complication or mortality risks in this patient group.
• These findings support the use of either technique based on clinical judgment and resource availability.