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Incisionless gastrostomy for nutritional support
Insights
Percutaneous endoscopic gastrostomy offers a safe and effective feeding tube placement for pediatric patients. This minimally invasive technique simplifies the procedure and reduces complications compared to traditional methods.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Endoscopy
Background:
- Percutaneous endoscopic gastrostomy (PEG) is a common procedure for long-term enteral nutrition.
- Traditional gastrostomy methods can involve significant risks and complications, particularly in pediatric patients.
- There is a need for safer and simpler gastrostomy techniques in children.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous endoscopic gastrostomy (PEG) in a pediatric and young adult population.
- To compare the outcomes of PEG with traditional gastrostomy methods.
- To assess the feasibility of performing PEG under local and topical anesthesia in eligible patients.
Main Methods:
- A cohort of 51 children and young adults (4 months to 26 years) underwent percutaneous endoscopic gastrostomy.
- Indications included malnutrition due to cystic fibrosis and central nervous system (CNS) disease.
- Procedures were performed using local/topical anesthesia or general anesthesia for younger children (<8 years).
Main Results:
- No procedure-related deaths occurred in the 51 patients.
- Significant complications were less frequent than with traditional gastrostomy.
- The procedure duration ranged from 20 to 60 minutes, with an average feeding gastrostomy maintenance of 5.6 months.
Conclusions:
- Percutaneous endoscopic gastrostomy is technically simpler and as safe as alternative gastrostomy methods.
- This technique is particularly beneficial for pediatric patients, potentially avoiding general anesthesia.
- PEG provides a safe and effective option for nutritional support in children and young adults requiring long-term feeding access.
Abstract:
A technique of percutaneous endoscopic gastrostomy was evaluated in 51 children and young adults aged 4 months to 26 years (mean, 9.7 years). Indications for gastrostomy included malnutrition secondary to cystic fibrosis, severe CNS disease, and others. The procedure was performed in 26 patients using local and topical anesthesia. General anesthesia was employed in children under 8 years of age. Duration of operative procedure ranged from 20 to 60 min. The average time for maintenance of feeding gastrostomy was 5.6 months. No procedure-related deaths were observed. Significant complications occurred less frequently than with traditional gastrostomy. We conclude that this procedure is technically simpler than, and at least as safe as, other methods of gastrostomy. It is especially useful in children for whom general anesthesia is best avoided.