Percutaneous endoscopic gastrostomy in children: 15 cases experience.
For long-term tube feeding in children, percutaneous endoscopic gastrostomy (PEG) has the advantages of a short surgical time, early feeding following surgery, and lower rate of complications. From July 2000 to September 2002, we enrolled fifteen children (mean age: 8.2 years old) who underwent PEG placement for long-term nutritional support. Their underlying diseases included mucopolysaccharidosis (MPS) type II severe form, mitochondrial disease, Ehlers-Danlos syndrome associated with Robin sequence, spinal muscular atrophy (SMA) type II, nesidioblastosis, neurofibromatosis and other neurological disorders. We assessed the complications and outcome in these patients after PEG placement. There were no difficulties in PEG tube-feeding after procedure. One patient had a wound infection at the insertion site which required parenteral antibiotic therapy. Symptomatic gastroesophageal reflux (GER) occurred in two patients and was controlled with medication. One patient developed a gastrocutaneous fistula, requiring surgical removal of the PEG tube. One patient underwent laparoscopic gastrojejunostomy and Nissen fundoplication for persistent vomiting. Two patients with mitochondrial disease expired. The other eleven devices have continued to function on follow-up. Placement of a PEG is a simple, feasible procedure for children with swallowing difficulty who require long-term nutritional support. Although complications may sometimes occur, in our experience many can be managed conservatively.
Yeh
Ting-Chi
TC
Department of Pediatrics, Mackay Memorial Hospital, No. 92, Sec. 2, Chung Shan North Road, Taipei, Taiwan.
Yeung
Chun-Yan
CY
Sheu
Jin-Cherng
JC
Lee
Hung-Chang
HC
Lin
Shuan-Pei
SP
Hsu
Chyong-Hsin
CH
Lee
Yann-Jinn
YJ
Chiu
Nan-Chang
NC
Ho
Che-Sheng
CS
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D016896:Treatment Outcome