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Comparison of Percutaneous Endoscopic Gastrostomy and Surgical Gastrostomy in Severely Handicapped Children
June Kim1, Min Lee1, Soon Chul Kim1
1Department of Pediatrics, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
Insights
Percutaneous endoscopic gastrostomy (PEG) is associated with fewer minor complications and shorter antibiotic use compared to surgical gastrostomy (SG). Early PEG insertion is recommended for nutritional support in patients requiring gastrostomy.
Area of Science:
- Gastroenterology
- Surgical Procedures
- Patient Outcomes
Background:
- Gastrostomy is a critical procedure for providing enteral nutrition to patients with severe disabilities.
- Percutaneous endoscopic gastrostomy (PEG) and surgical gastrostomy (SG) are common methods for achieving this nutritional support.
Purpose of the Study:
- To compare the outcomes and complication rates of PEG versus SG.
- To identify which gastrostomy method offers superior results for patient care.
Main Methods:
- A retrospective chart review was conducted on 51 patients who underwent gastrostomy between January 2000 and May 2016.
- Patient data, including complications and follow-up, were analyzed for both PEG and SG groups.
Main Results:
- No significant difference in major complication rates was observed between PEG (19.2%) and SG (20.0%).
- Minor complication rates were significantly lower in the PEG group (15.4%) compared to the SG group (52.0%) (p=0.006).
- Average antibiotic use was substantially shorter for PEG (6.2 days) than for SG (15.7 days) (p=0.002).
Conclusions:
- Percutaneous endoscopic gastrostomy (PEG) demonstrates a lower incidence of minor complications and reduced antibiotic requirements compared to surgical gastrostomy (SG).
- These findings support the recommendation for early consideration of PEG for nutritional support.
Purpose:
Gastrostomy is commonly used procedures to provide enteral nutrition support for severely handicapped patients. This study aimed to identify and compare outcomes and complications associated with percutaneous endoscopic gastrostomy (PEG) and surgical gastrostomy (SG).
Methods:
A retrospective chart review of 51 patients who received gastrostomy in a single tertiary hospital from January 2000 to May 2016 was performed. We analyzed the patients and the complications caused by the procedures.
Results:
Among the 51 patients, 26 had PEG and 25 had SG. Four cases in the SG group had fundoplication for gastroesophageal reflux disease. PEG and SG groups were followed up for an average of 29 months and 44 months. Major complications occurred in 19.2% of patients in the PEG group and 20.0% in the SG group, but significant differences between the groups were not observed. Minor complications occurred in 15.4% of patients in the PEG group and 52.0% in the SG group. Minor complications were significantly lower in the PEG group than in the SG group (p=0.006). The average use of antibiotics in the PEG and SG groups was 6.2 days and 15.7 days (p=0.002). Thirteen patients died of underlying disease but not related to gastrostomy, and only one patient died due to complications associated with general anesthesia.
Conclusion:
The duration of antibiotics use and incidence of minor complications were significantly lower in the PEG group than those in the SG group. Early PEG could be recommended for nutritional supports.