Percutaneous Endoscopic Gastrostomy in Pediatric Patients: Experience of 201 Cases in a Tertiary-Care Hospital
Lertudomphonwanit C, MD1, Butsriphum N, RN1, Prabpram W, RN1, Sumritsopak R, RN1, Tanpowpong P, MD, MPH1, Treepongkaruna S, MD1
Affiliation : 1 Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : Percutaneous endoscopic gastrostomy (PEG) has become a common technique for children who require long-term
enteral feeding. The use of PEG can improve nutritional status of patients and widely accepted by caregivers. The present study
revealed outcome of PEG in 201 children age <19 years performed by pediatric gastroenterologists in a tertiary-care hospital in
Thailand.
Materials and Methods : We retrospectively reviewed PEG registry of our division and medical records of pediatric patients (age
<19 years) who underwent PEG at Division of Gastroenterology, Department of Pediatrics, Ramathibodi Hospital from January
2001 to December 2013.
Results : Eighty-three percent of patients were neurologically impaired. The median weight was 9 kg (IQR 5.9 to 15.3) with a minimal
weight of 2.9 kg; 50% were underweight (weight for age Z-score less than -2 standard deviation) at time of PEG. Overall, rate of early
post-operative complications was 20%. Most of them were minor complications albeit 1.5% were major complications. There
was no mortality. At 1-year follow-up, nutritional status improved significantly. Mean weight for age Z-score was -2.13+2.1 before
PEG insertion and -1.38+1.9 at 1 year later (p = 0.0001). The proportion of underweight patients decreased from 45.3% to 39.7%.
Median increased weight was 38.9% (IQR 19.5 to 65.9).
Conclusion : PEG is a safe procedure for children, even in small infants, requiring long-term enteral feeding due to its favorable
outcomes in terms of better nutritional status and the low rate of major complications.
Keywords : Complications, Nutritional status, Pediatric outcomes, Percutaneous endoscopic gastrostomy
