title: Gastrostomy tube insertion in children: the Edmonton experience.
abstract: BACKGROUND
  Although gastrostomy tube insertion - whether endoscopic or open - is generally safe, procedure-related complications have been reported.
  
  
  OBJECTIVE
  To compare gastrostomy tube insertion-related complications between percutaneous endoscopic gastrostomy and open gastrostomy at a single pediatric centre.
  
  
  METHODS
  The charts of children (younger than 17 years of age at the time of tube insertion) who underwent endoscopic or open gastrostomy tube insertion from January 2005 to December 2007 at the Stollery Children's Hospital (Edmonton, Alberta) were examined.
  
  
  RESULTS
  A total of 298 children underwent gastrostomy tube insertion over a period of three years. After excluding patients with incomplete charts, 160 children (91 boys, mean [± SD] age 3.18 ± 4.73 years) were included. Eighty-five children (mean age 4.50 ± 5.40 years) had their gastrostomy tube inserted endoscopically, while the remaining 75 (mean age 1.68 ± 3.27 years; P<0.001) underwent an open procedure. The overall rate of major complications was 10.2% for the endoscopic technique and 8.6% for the open technique (P=0.1). Major infections were higher in the endoscopic technique group, while persistent gastrocutaneous fistulas after tube removal were more common in the open technique group.
  
  
  CONCLUSIONS
  Although the rate of major complications was similar between the endoscopic and open tube insertion groups, major infections were more common among children who underwent endoscopic gastrostomy. The decision for gastrostomy tube insertion was primarily based on clinical background.
authors.affiliation: Division of Gastroenterology, Faculty of Medicine, University of Alberta, Edmonton, Alberta, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Ackroyd
authors.forename: Meghana
authors.initials: M
authors.lastname: Saincher
authors.forename: Simon
authors.initials: S
authors.lastname: Cheng
authors.forename: Wael
authors.initials: W
authors.lastname: El-Matary
mesh_terms: D000416:Alberta; D002547:Cerebral Palsy / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D018662:Fundoplication; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007223:Infant; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D008297:Male