title: Percutaneous endoscopic gastrostomy without an antireflux procedure in neurologically disabled children.
abstract: In children with major neurologic impairment, gastrostomies are often used to alleviate malnutrition and feeding difficulties. There has been a trend toward performing "protective" antireflux surgery in these children. Nineteen children with major neurologic impairment and feeding failure were prospectively evaluated and followed up after placement of a percutaneous endoscopic gastrostomy (PEG) without any antireflux procedure. Mean age at PEG placement was 34 months with mean follow-up of 20.7 months. All parents would recommend PEG to families with disabled children, and if given the chance, 95% would elect PEG again for their child. No child developed choking, gagging, or retching postoperatively. At the time of follow-up, postoperative gastroesophageal reflux did not appear to be a major clinical problem.
authors.affiliation: Department of Pediatrics, University of Virginia, Charlottesville 22908, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Borowitz
authors.forename: J L
authors.initials: JL
authors.lastname: Sutphen
authors.forename: R L
authors.initials: RL
authors.lastname: Hutcheson
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000150:complications / Q000601:surgery*; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging / Q000601:surgery*; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome; D019564:Unnecessary Procedures