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Double-blind randomized clinical trial of percutaneous endoscopic gastrostomy versus radiologically inserted

R R Singh1, S A Nah1, D J Roebuck1

  • 1Department of Paediatric Surgery, UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital for Children, London, UK.

The British Journal of Surgery
|September 24, 2017
PubMed

Insights

Percutaneous endoscopic gastrostomy (PEG) and radiologically inserted gastrostomy (RIG) have similar complication rates in children. This randomized controlled trial found no significant difference in complications between PEG and RIG procedures.

Area of Science:

  • Pediatric Gastroenterology
  • Interventional Radiology
  • Surgical Outcomes

Background:

  • Gastrostomy tubes are essential for nutritional support in children.
  • Percutaneous endoscopic gastrostomy (PEG) and radiologically inserted gastrostomy (RIG) are common insertion methods.
  • Limited comparative data exists on complication rates between PEG and RIG in pediatric populations.

Purpose of the Study:

  • To compare the complication rates of PEG versus RIG in pediatric patients.
  • To evaluate the safety and efficacy of different gastrostomy insertion techniques.

Main Methods:

  • Randomized controlled trial (RCT) involving children requiring primary gastrostomy.
  • Patients were randomized to either PEG or RIG insertion.
  • Complications were assessed by blinded evaluators and analyzed using zero-inflated Poisson regression.

Main Results:

  • 214 children were randomized; 100 received PEG and 96 received RIG.
  • No statistically significant difference in the overall number of complications between PEG and RIG groups (P = 0.875).
  • Complication scores were similar, with RIG showing a non-significant trend towards higher scores (1.04 times, P = 0.597). Age was a significant factor, with older children having fewer complications.

Conclusions:

  • Both PEG and RIG are safe and effective methods for gastrostomy insertion in children.
  • The study demonstrated a low rate of major complications for both procedures.
  • ClinicalTrials.gov registration: NCT01920438.
Abstract

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