title: Comparison of operative outcomes between surgical gastrostomy and percutaneous endoscopic gastrostomy in infants.
abstract: OBJECTIVE
  Safety profile of different gastrostomy procedures in small children has not been well studied. This study was conducted to investigate whether complication and mortality rates differ between surgical gastrostomy (G-tube) and percutaneous endoscopic gastrostomy (PEG) in infants and neonates.
  
  
  METHODS
  In this retrospective study utilizing the Kids' Inpatient Database, all infants who underwent either G-tube or PEG as a sole procedure were identified. Variables included age, gender, race, presence of neurological impairment, prematurity, complex chronic condition, and severity of illness/risk of mortality subclasses. Postoperative complication, reoperation, and mortality rates were compared between G-tube and PEG. A subgroup of neonates was also analyzed.
  
  
  RESULTS
  A total of 1456 infants were identified (G-tube n=874, PEG n=582). In univariate analysis, the rates of adverse outcomes were not significantly different (G-tube vs PEG complication rate was 7.3% and 6.7%, p=0.65; mortality rate 1.3% and 0.7%, p=0.29, respectively). Adjusted odds ratios (ORs) for complication were 1.07 (G-tube vs PEG, 95% confidence interval [CI] 0.700-1.620) for overall infants and 1.19 (95% CI 0.601-2.350) for the neonatal subgroup. Similarly, adjusted ORs for mortality did not differ significantly both in infants (OR 1.749, 95% CI 0.532-5.755) and in the neonatal subgroup (OR 2.153, 95% CI 0.566-8.165).
  
  
  CONCLUSIONS
  When G-tube and PEG were performed as the only procedure throughout a hospitalization in infants and neonates, the two techniques had comparable risks of postoperative complications and mortalities.
  
  
  METHODS
  Retrospective comparative study, Level III.
authors.affiliation: Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, United States; Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, United States. Electronic address: drmiyatas@gmail.com.
authors.forename: Shin
authors.initials: S
authors.lastname: Miyata
authors.affiliation: Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, United States. Electronic address: fdong@westernu.edu.
authors.forename: Fanglong
authors.initials: F
authors.lastname: Dong
authors.affiliation: Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, United States; Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, United States. Electronic address: olga.lebedevskiy@gmail.com.
authors.forename: Olga
authors.initials: O
authors.lastname: Lebedevskiy
authors.affiliation: Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, United States. Electronic address: hanna.s.park@gmail.com.
authors.forename: Hanna
authors.initials: H
authors.lastname: Park
authors.affiliation: Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, United States. Electronic address: nanguyen@chla.usc.edu.
authors.forename: Nam
authors.initials: N
authors.lastname: Nguyen
mesh_terms: D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies
keywords: Complication; Gastrostomy; Infant; Kids' Inpatient Database; Percutaneous endoscopic gastrostomy