Pediatr Gastroenterol Hepatol Nutr.  2017 Mar;20(1):27-33. 10.5223/pghn.2017.20.1.27.

Comparison of Percutaneous Endoscopic Gastrostomy and Surgical Gastrostomy in Severely Handicapped Children

• Kim J
• Lee M
• Kim SC
• Joo CU
• Kim SJ

• KMID: 2375275
• DOI: http://doi.org/10.5223/pghn.2017.20.1.27

Abstract

PURPOSE
Gastrostomy is commonly used procedures to provide enteral nutrition support for severely handicapped patients. This study aimed to identify and compare outcomes and complications associated with percutaneous endoscopic gastrostomy (PEG) and surgical gastrostomy (SG).
METHODS
A retrospective chart review of 51 patients who received gastrostomy in a single tertiary hospital from January 2000 to May 2016 was performed. We analyzed the patients and the complications caused by the procedures.
RESULTS
Among the 51 patients, 26 had PEG and 25 had SG. Four cases in the SG group had fundoplication for gastroesophageal reflux disease. PEG and SG groups were followed up for an average of 29 months and 44 months. Major complications occurred in 19.2% of patients in the PEG group and 20.0% in the SG group, but significant differences between the groups were not observed. Minor complications occurred in 15.4% of patients in the PEG group and 52.0% in the SG group. Minor complications were significantly lower in the PEG group than in the SG group (p=0.006). The average use of antibiotics in the PEG and SG groups was 6.2 days and 15.7 days (p=0.002). Thirteen patients died of underlying disease but not related to gastrostomy, and only one patient died due to complications associated with general anesthesia.
CONCLUSION
The duration of antibiotics use and incidence of minor complications were significantly lower in the PEG group than those in the SG group. Early PEG could be recommended for nutritional supports.

Keyword

Gastrostomy; Endoscopy; Surgery; Complication

MeSH Terms

Anesthesia, General
Anti-Bacterial Agents
Disabled Children*
Disabled Persons*
Endoscopy
Enteral Nutrition
Fundoplication
Gastroesophageal Reflux
Gastrostomy*
Humans
Incidence
Nutritional Support
Retrospective Studies
Tertiary Care Centers
Anti-Bacterial Agents

Figure

• 

  Fig. 1 Clinical indications of children who required gastrostomy. PEG: percutaneous endoscopic gastrostomy, SG: surgical gastrostomy, CNS: central nervous system.

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