title: Single-center experience with 1-step low-profile percutaneous endoscopic gastrostomy in children.
abstract: OBJECTIVE
  The 1-step low-profile percutaneous endoscopic gastrostomy (1-step PEG) uses a single procedure that allows immediate use of a low-profile device. The aim of the present study was to provide our experience with this device and to analyze complications and outcomes after the initial placement.
  
  
  METHODS
  We performed a retrospective chart review of pediatric patients with 1-step PEG placement done by our pediatric gastroenterologists between 2006 and June 2011. Patients were studied for a minimum period of 6 months.
  
  
  RESULTS
  A total of 121 patients were included in our study, with 23% infants. The most common indication for 1-step PEG placement was swallowing dysfunction in children with neurological impairment (49%). Postplacement complications included granulation tissue (52%), cellulitis (23%), leakage (21%), vomiting (17%), tissue breakdown (8%), failed placement (6%), embedded bolster (5%), perforation (0.8%), and bowel obstruction (0.8%). One-step PEG was maintained in 46 patients (38%). In the remaining 75 patients (62%), PEGs were changed to a balloon device in 66 patients and were completely removed in 9 patients. The most common indications for change were damaged PEG (19/75) and issues with size (11/75). The time to change ranged from <1 month to >4 years (14 ± 1.3 months). Sixty-eight percent of 1-step PEG changes/removal was performed with an obturator under brief inhalated anesthesia.
  
  
  CONCLUSIONS
  The 1-step PEG has complication rates and outcomes comparable with standard PEGs.
authors.affiliation: Division of Gastroenterology and Nutrition, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Nicole
authors.initials: N
authors.lastname: Pattamanuch
authors.forename: Inna
authors.initials: I
authors.lastname: Novak
authors.forename: Anthony
authors.initials: A
authors.lastname: Loizides
authors.forename: Andrea
authors.initials: A
authors.lastname: Montalvo
authors.forename: John
authors.initials: J
authors.lastname: Thompson
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Rivas
authors.forename: Debra
authors.initials: D
authors.lastname: Pan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery; D005260:Female; D005773:Gastroscopy / Q000295:instrumentation / Q000379:methods*; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009422:Nervous System Diseases / Q000150:complications; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult