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http://dx.doi.org/10.5223/pghn.2014.17.4.214

Short-Term Complications of Percutaneous Endoscopic Gastrostomy according to the Type of Technique  

Gang, Mi Hyeon (Department of Pediatrics, Chungnam National University School of Medicine)
Kim, Jae Young (Department of Pediatrics, Chungnam National University School of Medicine)
Publication Information
Pediatric Gastroenterology, Hepatology & Nutrition / v.17, no.4, 2014 , pp. 214-222 More about this Journal
Abstract
Purpose: The method of percutaneous endoscopic gastrostomy (PEG) tube placement can be divided into the pull and introducer techniques. We compared short-term complications and prognosis between patients who underwent the pull technique and two other types of introducer techniques, the trocar introducer technique and T-fastener gastropexy technique. Methods: Twenty-six patients who underwent PEG were enrolled in this study. We retrospectively investigated the age, sex, body weight, weight-for-age Z-score, underlying diseases, PEG indications, complications, duration of NPO (nil per os), pain control frequency, and duration of antibiotic therapy. The patients were classified into three groups according to the PEG technique. The occurrence of complications was monitored for 10 weeks after the procedure. Results: The age, sex, body weight, and weight-for-age Z-score were not significantly between the three groups. Most patients had cerebral palsy and seizure disorders. Dysphagia was the most common indication for PEG. Major complications occurred in 5 (50%), 4 (66.7%), and 0 (0%) patients in group I, II, and III, respectively (p=0.005). Further, peristomal infection requiring systemic antibiotic therapy occurred in 2 (20%), 3 (50%), and 0 (0%) patients in group I, II, and III, respectively (p=0.04). There was no significant difference between the groups with respect to minor complications, duration of NPO, pain control frequency, and duration of antibiotic therapy. Conclusion: The results indicate that the T-fastener gastropexy technique was associated with the lowest rate of major complications.
Keywords
Gastrostomy; Complications;
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1 Russell TR, Brotman M, Norris F. Percutaneous gastrostomy. A new simplified and cost-effective technique. Am J Surg 1984;148:132-7.   DOI   ScienceOn
2 Campoli PM, Cardoso DM, Turchi MD, Ejima FH, Mota OM. Assessment of safety and feasibility of a new technical variant of gastropexy for percutaneous endoscopic gastrostomy: an experience with 435 cases. BMC Gastroenterol 2009;9:48.   DOI   ScienceOn
3 Terry NE, Boswell WC, Carney DE, Beck A, Lowe L, Rittmeyer C. Percutaneous endoscopic gastrostomy with T-bar fixation in children and infants. Surg Endosc 2008;22:167-70.   DOI
4 Fox VL, Abel SD, Malas S, Duggan C, Leichtner AM. Complications following percutaneous endoscopic gastrostomy and subsequent catheter replacement in children and young adults. Gastrointest Endosc 1997;45:64-71.   DOI   ScienceOn
5 Fortunato JE, Troy AL, Cuffari C, Davis JE, Loza MJ, Oliva-Hemker M, et al. Outcome after percutaneous endoscopic gastrostomy in children and young adults. J Pediatr Gastroenterol Nutr 2010;50:390-3.
6 Kohler G, Kalcher V, Koch OO, Luketina RR, Emmanuel K, Spaun G. Comparison of 231 patients receiving either "pull-through" or "push" percutaneous endoscopic gastrostomy. Surg Endosc 2014. [Epub ahead of print]
7 Liu R, Jiwane A, Varjavandi A, Kennedy A, Henry G, Dilley A, et al. Comparison of percutaneous endoscopic, laparoscopic and open gastrostomy insertion in children. Pediatr Surg Int 2013;29:613-21.   DOI   ScienceOn
8 Ljungdahl M, Sundbom M. Complication rate lower after percutaneous endoscopic gastrostomy than after surgical gastrostomy: a prospective, randomized trial. Surg Endosc 2006;20:1248-51.   DOI
9 Pennington C. To PEG or not to PEG. Clin Med 2002;2:250-5.   DOI   ScienceOn
10 Lim CH, Park JM, Cho YK, Lee IS, Kim SW, Choi MG, et al. Successful control of peristomal infection by introducer-type percutaneous endoscopic gastrostomy: a retrospective historical control study. Dig Dis Sci 2011;56:2024-9.   DOI
11 Martins FP, Sousa MC, Ferrari AP. New "introducer" PEG-gastropexy with T fasteners: a pilot study. Arq Gastroenterol 2011;48:231-5.   DOI
12 Shigoka H, Maetani I, Tominaga K, Gon K, Saitou M, Takenaka Y. Comparison of modified introducer method with pull method for percutaneous endoscopic gastrostomy: prospective randomized study. Dig Endosc 2012;24:426-31.   DOI   ScienceOn
13 Maetani I, Tada T, Ukita T, Inoue H, Sakai Y, Yoshikawa M. PEG with introducer or pull method: a prospective randomized comparison. Gastrointest Endosc 2003;57:837-41.   DOI   ScienceOn
14 Campoli PM, de Paula AA, Alves LG, Turchi MD. Effect of the introducer technique compared with the pull technique on the peristomal infection rate in PEG: a meta-analysis. Gastrointest Endosc 2012;75:988-96.   DOI   ScienceOn
15 Tucker AT, Gourin CG, Ghegan MD, Porubsky ES, Martindale RG, Terris DJ. 'Push' versus 'pull' percutaneous endoscopic gastrostomy tube placement in patients with advanced head and neck cancer. Laryngoscope 2003;113:1898-902.
16 Taylor CA, Larson DE, Ballard DJ, Bergstrom LR, Silverstein MD, Zinsmeister AR, et al. Predictors of outcome after percutaneous endoscopic gastrostomy: a community-based study. Mayo Clin Proc 1992;67:1042-9.   DOI   ScienceOn
17 Brewster BD, Weil BR, Ladd AP. Prospective determination of percutaneous endoscopic gastrostomy complication rates in children: still a safe procedure. Surgery 2012;152:714-9; discussion 719-21.   DOI   ScienceOn
18 Gauderer MW. Percutaneous endoscopic gastrostomy: a 10-year experience with 220 children. J Pediatr Surg 1991;26:288-92; discussion 292-4.   DOI   ScienceOn
19 Khattak IU, Kimber C, Kiely EM, Spitz L. Percutaneous endoscopic gastrostomy in paediatric practice: complications and outcome. J Pediatr Surg 1998;33:67-72.   DOI   ScienceOn
20 Avitsland TL, Kristensen C, Emblem R, Veenstra M, Mala T, Bjornland K. Percutaneous endoscopic gastrostomy in children: a safe technique with major symptom relief and high parental satisfaction. J Pediatr Gastroenterol Nutr 2006;43:624-8.   DOI   ScienceOn
21 Vervloessem D, van Leersum F, Boer D, Hop WC, Escher JC, Madern GC, et al. Percutaneous endoscopic gastrostomy (PEG) in children is not a minor procedure: risk factors for major complications. Semin Pediatr Surg 2009;18:93-7.   DOI   ScienceOn
22 Van Biervliet S, Van Renterghem K, Vande Putte D, Vande Velde S, De Bruyne R, Van Winckel M. Gastrostomy use in children: a 3-year single centre experience. Acta Gastroenterol Belg 2014;77:8-12.
23 Frohlich T, Richter M, Carbon R, Barth B, Kohler H. Review article: percutaneous endoscopic gastrostomy in infants and children. Aliment Pharmacol Ther 2010;31:788-801.
24 Lipp A, Lusardi G. Systemic antimicrobial prophylaxis for percutaneous endoscopic gastrostomy. Cochrane Database Syst Rev 2006;(4):CD005571.
25 Jafri NS, Mahid SS, Minor KS, Idstein SR, Hornung CA, Galandiuk S. Meta-analysis: antibiotic prophylaxis to prevent peristomal infection following percutaneous endoscopic gastrostomy. Aliment Pharmacol Ther 2007;25:647-56.   DOI   ScienceOn
26 Lipp A, Lusardi G. A systematic review of prophylactic antimicrobials in PEG placement. J Clin Nurs 2009;18:938-48.   DOI   ScienceOn
27 Choudhry U, Barde CJ, Markert R, Gopalswamy N. Percutaneous endoscopic gastrostomy: a randomized prospective comparison of early and delayed feeding. Gastrointest Endosc 1996;44:164-7.   DOI   ScienceOn
28 Abuksis G, Mor M, Plaut S, Fraser G, Niv Y. Outcome of percutaneous endoscopic gastrostomy (PEG): comparison of two policies in a 4-year experience. Clin Nutr 2004;23:341-6.   DOI   ScienceOn
29 Gauderer MW, Ponsky JL, Izant RJ Jr. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg 1980;15:872-5.   DOI   ScienceOn
30 Ponsky JL, Gauderer MW. Percutaneous endoscopic gastrostomy: a nonoperative technique for feeding gastrostomy. Gastrointest Endosc 1981;27:9-11.   DOI   ScienceOn
31 El-Matary W. Percutaneous endoscopic gastrostomy in children. Can J Gastroenterol 2008;22:993-8.
32 Lynch CR, Fang JC. Prevention and management of complications of percutaneous endoscopic gastrostomy (PEG) tubes. Pract Gastroenterol 2004;28:66-76.
33 Lee SP, Lee KN, Lee OY, Lee HL, Jun DW, Yoon BC, et al. Risk factors for complications of percutaneous endoscopic gastrostomy. Dig Dis Sci 2014;59:117-25.   DOI   ScienceOn