title: Complications of percutaneous endoscopic gastrostomy in children: results of an Italian multicenter observational study.
abstract: BACKGROUND
  Percutaneous endoscopic gastrostomy is the preferred way to achieve an artificial feeding route for patients requiring long-term enteral nutrition. Although the procedure is well-standardized, it carries early and late complications.
  
  
  OBJECTIVE
  To establish the mortality and morbidity of this technique in a large cohort of children.
  
  
  METHODS
  A multi-centre prospective clinical data collection from children undergoing percutaneous endoscopic gastrostomy tube implantation has been conducted from January 2004 to December 2007. Previous abdominal surgery was the only exclusion criterion. Follow-up visits were carried out at 1, 3, 6, 12, and 24 months after the procedure.
  
  
  RESULTS
  239 children (males, 55.2%; mean age 6.05±6.1years) were enrolled from nine tertiary Italian centres. Major complications occurred in 8 patients (3.3%). The cumulative incidence of complications was 47.7% at 24 months. The presence of thoraco-abdominal deformity was an independent predictor of complications at 12 months. No risk factors were identified in association to complications during the 1st tube replacement.
  
  
  CONCLUSIONS
  In children undergoing percutaneous endoscopic gastrostomy placement minor complications are common, while severe morbidities are rare. Accurate follow up is essential to recognize every complication, in particular when risk factors such as thoraco-abdominal deformity exist.
authors.affiliation: Pediatric Surgery Unit, University of Padova, Padua, Italy. f.fascettileon@gmail.com
authors.forename: Francesco
authors.initials: F
authors.lastname: Fascetti-Leon
authors.forename: PierGiorgio
authors.initials: P
authors.lastname: Gamba
authors.forename: Luigi
authors.initials: L
authors.lastname: Dall'Oglio
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pane
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: dé Angelis
authors.forename: Barbara
authors.initials: B
authors.lastname: Bizzarri
authors.forename: Giorgio
authors.initials: G
authors.lastname: Fava
authors.forename: Luciano
authors.initials: L
authors.lastname: Maestri
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cheli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Nardo
authors.forename: Antonio
authors.initials: A
authors.lastname: La Riccia
authors.forename: Saverio
authors.initials: S
authors.lastname: Marrello
authors.forename: Paolo
authors.initials: P
authors.lastname: Gandullia
authors.forename: Claudio
authors.initials: C
authors.lastname: Romano
authors.forename: Lorenzo
authors.initials: L
authors.lastname: D'Antiga
authors.forename: Pietro
authors.initials: P
authors.lastname: Betalli
mesh_terms: D000005:Abdomen / Q000002:abnormalities; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000209:etiology; D003108:Colonic Diseases / Q000209:etiology* / Q000601:surgery; D017577:Cutaneous Fistula / Q000209:etiology* / Q000601:surgery; D004750:Enteral Nutrition; D005260:Female; D005747:Gastric Fistula / Q000209:etiology* / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007412:Intestinal Fistula / Q000209:etiology* / Q000601:surgery; D007558:Italy; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D010538:Peritonitis / Q000209:etiology / Q000601:surgery; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology; D013909:Thorax / Q000002:abnormalities; D055815:Young Adult