Percutaneous endoscopic gastrostomy in children: a population-based study from iceland, 1999-2010.

• Published in: Journal of Laparoendoscopic & Advanced Surgical Techniques
• Main Authors: Viktorsdóttir, Margrét Brands, Óskarsson, Kristján, Gunnarsdóttir, Anna, Sigurdsson, Luther
• Other Authors: 1 Landspitali Univ Hosp, Dept Surg, Reykjavik, Iceland 2 Landspitali Univ Hosp, Dept Pediat Surg, Reykjavik, Iceland 3 Karolinska Univ Hosp, Astrid Lindgren Children Hosp, Dept Pediat Surg, Stockholm, Sweden 4 Univ Wisconsin, Sch Med & Publ Hlth, Dept Pediat, Madison, WI 53792 USA
• Format: Article in Journal/Newspaper
• Language: English
• Published: Mary Ann Liebert 2015
• Subjects: Magaspeglun; Börn; Gastroscopy; Gastrostomy/adverse effects; Gastrostomy/methods*; Infant; Child; Preschool; Enteral Nutrition; Iceland
• Online Access: http://hdl.handle.net/2336/561076; https://doi.org/10.1089/lap.2014.0296

To access publisher's full text version of this article click on the hyperlink at the bottom of the page The aim of this study was to review the indications and the results of percutaneous endoscopic gastrostomy (PEG) procedures in Icelandic children. A retrospective review of all pediatric PEG procedures performed in Iceland in 1999-2010 was conducted. Diagnosis, demographics, complications, and body mass index were recorded. Ninety-eight children (51 girls) were included. Median age was 2 years (range, 1 month-17 years). The most common diagnosis was neurological disease (56%). Median length of stay was 4 days (range, 1-189 days). Extended length of stay was not related to PEG. Before surgery, median body mass index (BMI) was 14.5 kg/m(2) (range, 9.8-20.8 kg/m(2)), and the median BMI-for-age z-score was -1.4 (range, -5.9 to 3.0). One year after surgery, median BMI was 15.3 kg/m(2) (range, 11.2-22.1 kg/m(2)), and median BMI-for-age z-score was -0.5 (range, -5.1 to 3.8). The median weight increased significantly in 1 year by 1.0 standard deviation (P<.0001; 95% confidence interval, -1.4820 to -0.7387). One hundred sixty-six complications were recorded in 65 children; 96% were minor, with the most common being granuloma formation (19%) and superficial skin infection (25%). The rate of infection was not statistically different between those who received preoperative antibiotics versus no antibiotics (P=.296). Major complications were peritonitis (n=3), esophageal tear (n=1), buried bumper (n=1), and malposition of the gastrostomy tube (n=1). Median follow-up was 47 months (range, 1-152 months). Fourteen children died (at 1 month to 3 years), but no deaths were related to PEG insertion. Twenty-seven children were without gastrostomy at follow-up. Twelve children (14%) underwent fundoplication later; 11 of them were neurologically impaired. PEG is a safe technique with a high complication rate, but the majority of complications are minor and easily treatable. Gastrostomy is sometimes temporary. Enteral ...