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Percutaneous endoscopic gastrostomy in children: A tertiary center experience
Osama Bawazir1,2, Abdulaziz M Banaja3, Razan Bawazir4
1Department of Surgery Faculty of Medicine, Umm Al-Qura University at Makkah, Makkah, Saudi Arabia.
Insights
Percutaneous endoscopic gastrostomy (PEG) is safe and effective in pediatric patients, including those with cardiac conditions, VP shunts, or PD catheters. Outcomes demonstrate a low complication rate, supporting its feasibility in diverse pediatric populations.
Area of Science:
- Pediatric Gastroenterology
- Surgical Procedures
- Patient Outcomes
Background:
- Percutaneous endoscopic gastrostomy (PEG) is a common pediatric procedure.
- Associated comorbidities can influence PEG outcomes.
- Evaluating PEG safety and efficacy in specific pediatric subgroups is crucial.
Purpose of the Study:
- To assess the outcomes and safety of PEG tube placement in pediatric patients.
- To specifically analyze PEG outcomes in children with cardiac disease, ventriculoperitoneal (VP) shunts, or peritoneal dialysis (PD) catheters.
Main Methods:
- Retrospective analysis of 113 pediatric patients undergoing PEG insertion between 2011 and 2021.
- Inclusion of patients with cardiac disease (15.93%), PD catheters (4.42%), and VP shunts (2.65%).
- Evaluation of complication rates, operative time, and mortality associated with PEG procedures.
Main Results:
- Neurological disease was the most common indication for PEG (49.56%).
- The most frequent complications were pneumonia and vomiting (17.7%).
- No significant differences in postoperative complications were observed among patients with cardiac diseases, PD catheters, or VP shunts; VP shunt patients had no reported complications.
Conclusions:
- PEG is a feasible and safe procedure in pediatric patients, including those with complex comorbidities.
- Low complication rates were observed in patients with cardiac disease, VP shunts, and PD catheters.
- PEG demonstrates a favorable safety profile across various pediatric patient groups.
Introduction:
Percutaneous endoscopic gastrostomy (PEG) is a common procedure in children. The outcomes of PEG could be affected by the associated disease. We aimed to evaluate the outcomes and safety of PEG tube placement in a tertiary care center with special attention to patients with cardiac disease, ventriculoperitoneal (VP) shunt, or peritoneal dialysis (PD) catheter.
Methods:
This retrospective study included 113 pediatric patients who had PEG tube insertion from 2011 to 2021. Eighteen patients (15.93%) had cardiac disease, five patients (4.42%) had PD catheters, and three patients (2.65%) had VP shunt.
Results:
The median age was 3 years (interquartile range: 1-6), and females represented 55% of our patients. The weight ranged from 2.57 to 60 kg, and the most common indication for insertion was neurological disease (n = 56; 49.56%). The median operative time was 30 (20-45) minutes. Pneumonia and vomiting were the most frequent complications (n = 20, 17.7%). Thirty-day mortality occurred in four patients (3.54%) and 1-year mortality in 10 patients (8.85%). Nine patients (7.96%) required fundoplication, and four patients (3.53%) had tube removal and reinsertion. There was no association between weight and postoperative complications (odds ratio: 0.97; P = .48). There were no differences in postoperative complications among patients with cardiac diseases, PD catheters, and VP shunts. No complications were reported in patients with VP shunt. One patient with cardiac disease and one patient with PD catheter required fundoplication. Removal and reinsertion were needed in one patient with a PD catheter.
Conclusion:
PEG is feasible in low-weight infants with a low complication rate. The complication rate is low in patients with VP shunt, PD catheter, and cardiac patients.
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