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Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy Reduces Major Complications in High-Risk Pediatric Patients

Brigitta Balogh1, Dániel Szűcs2, Gabriella Gavallér2

  • 1Division of Surgery, Department of Pediatrics, University of Szeged, Szeged, Hungary.

Pediatric Gastroenterology, Hepatology & Nutrition
|May 28, 2021
PubMed

Insights

Laparoscopic-assisted PEG (L-PEG) may be safer for high-risk pediatric patients than conventional PEG, with fewer major complications. L-PEG is recommended for these complex cases to improve patient outcomes.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Minimally Invasive Procedures

Background:

  • Percutaneous endoscopic gastrostomy (PEG) is a standard feeding tube placement method.
  • High-risk pediatric patients present unique challenges for conventional PEG.
  • Comparing conventional PEG with laparoscopic-assisted PEG (L-PEG) is crucial for optimizing care.

Purpose of the Study:

  • To compare the outcomes of conventional PEG and L-PEG in high-risk pediatric patients.
  • To evaluate complication rates and safety profiles of both procedures.
  • To determine the preferred method for gastrostomy tube placement in complex pediatric cases.

Main Methods:

  • Retrospective analysis of 90 PEG insertions (2014-2019) in a tertiary pediatric center.
  • Inclusion criteria for high-risk: severe thoracoabdominal deformity (TAD), prior abdominal surgery, ventriculoperitoneal (VP) shunt, or abdominal tumors.
  • Comparison of operative time, complications, and mortality between conventional PEG (n=15) and L-PEG (n=10).

Main Results:

  • No major complications occurred in the L-PEG group (n=10).
  • The conventional PEG group (n=15) experienced three major complications (20%): colon perforation, gastrocolic fistula, and pneumoperitoneum.
  • Minor complications included unplanned PEG removal and peristomal granuloma in both groups.

Conclusions:

  • Laparoscopic-assisted PEG (L-PEG) demonstrates a superior safety profile in high-risk pediatric patients compared to conventional PEG.
  • L-PEG is recommended for gastrostomy tube placement in pediatric patients with significant comorbidities.
  • Minimally invasive techniques like L-PEG can reduce major adverse events in complex surgical cases.
Abstract

Keywords:
ChildComplicationsGastrostomyLaparoscopyPercutaneous

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