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[Percutaneous endoscopic gastrostomy in childhood and adolescence]
R Behrens1, H Muschweck, T Richter
1Universitätsklinik für Kinder und Jugendliche Erlangen-Nürnberg.
Insights
Percutaneous endoscopic gastrostomy (PEG) offers a safe and effective alternative to nasogastric tube feeding for children needing long-term nutritional support. This method significantly improves quality of life with a low complication rate.
Area of Science:
- Pediatric Gastroenterology
- Minimally Invasive Procedures
- Nutritional Support
Context:
- Nasogastric tube feeding is common for chronically ill children but presents challenges like hypopharyngeal irritation and dislocation.
- Percutaneous endoscopic gastrostomy (PEG) provides an alternative to mitigate these disadvantages.
- Limited pediatric experience exists for PEG procedures.
Purpose:
- To evaluate the safety and efficacy of percutaneous endoscopic gastrostomy (PEG) in a pediatric population.
- To assess indications, outcomes, and complications associated with PEG in children.
- To determine the suitability of PEG for long-term tube feeding in pediatric patients.
Summary:
- This study reports on 89 children undergoing PEG for indications including central dysphagia, dystrophy, special diets, and gastric volvulus.
- PEGs were placed in the stomach (73) or duodenum (16), with a mean duration exceeding one year.
- Observed complications (14) included site inflammation, perforation, dislocation, and retention disk issues, with no procedure-related deaths.
Impact:
- Percutaneous endoscopic gastrostomy (PEG) is a viable and beneficial option for pediatric patients requiring long-term tube feeding.
- The procedure is associated with a low complication rate and enhances the quality of life for dependent children.
- PEG should be considered for all pediatric patients, including infants, needing extended nutritional support.
Background:
Nasogastric tube-feeding often is necessary in the treatment of chronically ill patients. The disadvantage (irritation of the hypopharynx, dislocation, stigma) can be avoided by the percutaneous endoscopic gastrostomy (PEG). In childhood there is only limited experience with this techniques.
Patients And Method:
We report about 89 children with PEG. Indications were central dysphagia (67), dystrophy caused by chronic renal failure or congenital heart disease (15), application of special diets (6) and gastric volvulus (1). The endoscopy was done in sedation.
Results:
The PEG was placed in the stomach (73) or duodenum (16). 14 Complications were observed: inflammation at the insertion site (2), perforation (2, healing under conservative treatment), dislocation of the duodenal part into the stomach or occlusion (6) and distraction of the retention disk (4). There were no procedures-related deaths. The mean duration of the PEG was more than 1 year. The affected persons were very pleased with the efficacy of this treatment.
Conclusions:
In all patients (including infants) requiring long-term tube-feeding the option of a PEG should be taken into consideration. In our experience the PEG is associated with a low rate of complications and provides a major improvement for children who are dependent on tube feeding.