Complications after pediatric percutaneous endoscopic gastrostomy: comparison of the push and pull technique

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Medical Devices

Background:

• Percutaneous endoscopic gastrostomy (PEG) is a common procedure in children.
• Complications associated with PEG procedures can be significant.
• The push technique for PEG placement is increasingly utilized, but its safety profile requires further characterization.

Purpose of the Study:

• To assess the overall complication rate of PEG procedures in pediatric patients.
• To compare the safety and complication profiles of the push versus pull PEG techniques.
• To identify long-term morbidity associated with gastrostomies in children.

Main Methods:

• Retrospective review of pediatric patients undergoing PEG procedures between 2002 and 2020.
• Analysis of complication rates, types (minor/major), and reoperation rates for both push and pull techniques.
• Evaluation of long-term follow-up data to assess morbidity.

Main Results:

• A total of 217 PEG procedures were performed in 216 children; 64% used the push technique and 36% the pull technique.
• The overall complication rate was high at 57%, with complications occurring years post-procedure.
• The pull technique group had higher rates of minor complications (63% vs. 48%) and reoperations (17% vs. 7%) compared to the push technique group.

Conclusions:

• PEG procedures in children are associated with a high overall complication rate, though most are minor.
• The push PEG technique demonstrates a safer profile than the traditional pull technique.
• Gastrostomies in children can lead to significant long-term morbidity.