title: Outcomes of percutaneous endoscopic gastrostomy in children.
abstract: Percutaneous endoscopic gastrostomy (PEG) is a relatively safe and minimally invasive surgical method for providing enteral access in children. In pediatrics, the indications for PEG placement frequently include malnutrition or failure to thrive, as well as oropharyngeal dysphagia, especially in children with neurological impairment (NI). The risk for postoperative complications is low. However, among children with NI, gastroesophageal reflux disease (GERD) may necessitate fundoplication prior to gastrostomy tube placement. Preoperative pH probe testing has not been shown to be an effective screening tool prior to PEG placement among patients with GERD. Laparoscopic gastrostomy tube insertion was introduced in pediatric patients in an attempt to decrease complications associated with PEG. Although outcomes were reported to be similar to or better than PEG alone, future comparative studies are needed to better define the optimal patient demographic for this technique.
authors.affiliation: Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, The Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. jfortuna@wfubmc.edu
authors.forename: John E
authors.initials: JE
authors.lastname: Fortunato
authors.forename: Carmen
authors.initials: C
authors.lastname: Cuffari
mesh_terms: D002648:Child; D004750:Enteral Nutrition / Q000379:methods; D005183:Failure to Thrive / Q000601:surgery; D005764:Gastroesophageal Reflux / Q000209:etiology*; D005773:Gastroscopy; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D044342:Malnutrition / Q000517:prevention & control / Q000601:surgery