title: Fluoroscopy-guided Percutaneous Endoscopic Gastrostomy in Children: A Simple and Safe Technique.
abstract: Percutaneous endoscopic gastrostomy (PEG) is a widely used minimally invasive procedure. However, PEG is difficult in neurologically impaired patients due to scoliosis with a high-riding stomach and intestinal dilatation. Fluoroscopy-guided PEG (F-PEG) is expected to avoid PEG-related complications such as intestinal injury and malpositioned tube placement. The aim of this retrospective study is to evaluate the feasibility and safety of F-PEG in children. Twenty-one handicapped pediatric patients underwent F-PEG from January 2012 to December 2014 at our hospital. Among them, 6 had scoliosis, 7 had a high-riding stomach, and 3 had gastric volvulus. F-PEG was performed in all 21 patients without any major complications. The median procedure duration was 22 minutes. In 1 patient with severe scoliosis (Cobb angle, 118 degrees) and a high-riding stomach, F-PEG was safely performed. In conclusion, F-PEG is a simple and feasible technique, and can reduce the risk of PEG-related complications in handicapped pediatric patients.
authors.affiliation: *Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita †Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Zenitani
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Uehara
authors.forename: Keigo
authors.initials: K
authors.lastname: Nara
authors.forename: Takehisa
authors.initials: T
authors.lastname: Ueno
authors.forename: Hideki
authors.initials: H
authors.lastname: Soh
authors.forename: Noriaki
authors.initials: N
authors.lastname: Usui
authors.forename: Hiroomi
authors.initials: H
authors.lastname: Okuyama
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D005500:Follow-Up Studies; D005773:Gastroscopy / Q000379:methods*; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*