title: Long-term outcome after percutaneous endoscopic gastrostomy in children.
abstract: BACKGROUND
  Percutaneous endoscopic gastrostomy (PEG) is widely accepted as the preferred procedure to establish long-term enteral feeding.
  
  
  OBJECTIVE
  To learn the long-term outcomes of the patients who have undergone PEG placement, we reviewed our experience with children who underwent this procedure in our institute.
  
  
  METHODS
  A total of 83 pediatric patients (42 males and 41 females), who were aged from 3 months to 20 years, underwent PEG insertion in National Taiwan University Hospital from January 2000 to April 2011. The underlying diseases of the patients receiving PEG were neurological dysfunction (n = 67), metabolic disorders (n = 9), gastrointestinal disease (n = 2), and congenital heart disease (n = 1). This procedure was performed under intravenous sedation or under general anesthesia. Prophylactic antibiotics were administered for 1 day. Tube feeding began 24 hours after the PEG placement. The body weight of the patients was recorded 1 day before PEG placement and at least 6 months after PEG placement.
  
  
  RESULTS
  The weight-for-age Z-score before and at 6 months after PEG placement were -1.5 ± 2.0 and -0.9 ± 2.1, respectively, which was statistically significant (paired t test, p = 0.006). The catch-up growth was recorded after PEG placement. Complications of PEG in our patients included cellulitis at the gastrostomy wound (n = 14), dislodgement of the tube (n = 17), and persistent gastrocutaneous fistula (n = 3). The PEG tube was removed permanently in seventeen patients because they resumed an adequate oral intake. During the follow-up period, 14 patients died of an underlying disease or infection.
  
  
  CONCLUSIONS
  Our experience confirmed that PEG placement is a good long-term route for nutritional supply with no serious complications in children.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Fu-Yu
authors.initials: FY
authors.lastname: Wu
authors.forename: Jia-Feng
authors.initials: JF
authors.lastname: Wu
authors.forename: Yen-Hsuan
authors.initials: YH
authors.lastname: Ni
mesh_terms: D000293:Adolescent; D000328:Adult; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition; D005260:Female; D005773:Gastroscopy; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male; D016896:Treatment Outcome
keywords: endoscopy; gastrostomy; outcome