title: Percutaneous endoscopic gastrostomy in children: a population-based study from iceland, 1999-2010.
abstract: OBJECTIVE
  The aim of this study was to review the indications and the results of percutaneous endoscopic gastrostomy (PEG) procedures in Icelandic children.
  
  
  METHODS
  A retrospective review of all pediatric PEG procedures performed in Iceland in 1999-2010 was conducted. Diagnosis, demographics, complications, and body mass index were recorded.
  
  
  RESULTS
  Ninety-eight children (51 girls) were included. Median age was 2 years (range, 1 month-17 years). The most common diagnosis was neurological disease (56%). Median length of stay was 4 days (range, 1-189 days). Extended length of stay was not related to PEG. Before surgery, median body mass index (BMI) was 14.5 kg/m(2) (range, 9.8-20.8 kg/m(2)), and the median BMI-for-age z-score was -1.4 (range, -5.9 to 3.0). One year after surgery, median BMI was 15.3 kg/m(2) (range, 11.2-22.1 kg/m(2)), and median BMI-for-age z-score was -0.5 (range, -5.1 to 3.8). The median weight increased significantly in 1 year by 1.0 standard deviation (P<.0001; 95% confidence interval, -1.4820 to -0.7387). One hundred sixty-six complications were recorded in 65 children; 96% were minor, with the most common being granuloma formation (19%) and superficial skin infection (25%). The rate of infection was not statistically different between those who received preoperative antibiotics versus no antibiotics (P=.296). Major complications were peritonitis (n=3), esophageal tear (n=1), buried bumper (n=1), and malposition of the gastrostomy tube (n=1). Median follow-up was 47 months (range, 1-152 months). Fourteen children died (at 1 month to 3 years), but no deaths were related to PEG insertion. Twenty-seven children were without gastrostomy at follow-up. Twelve children (14%) underwent fundoplication later; 11 of them were neurologically impaired.
  
  
  CONCLUSIONS
  PEG is a safe technique with a high complication rate, but the majority of complications are minor and easily treatable. Gastrostomy is sometimes temporary. Enteral feeding results in significant weight gain in 1 year.
authors: 1 Department of Surgery, Landspitali University Hospital , Reykjavík, Iceland .
authors: Margrét Brands
authors: MB
authors: Viktorsdóttir
authors: Kristján
authors: K
authors: Óskarsson
authors: Anna
authors: A
authors: Gunnarsdóttir
authors: Luther
authors: L
authors: Sigurdsson
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007055:Iceland; D007223:Infant; D008297:Male; D009422:Nervous System Diseases / Q000401:mortality / Q000628:therapy*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D015430:Weight Gain