Moderator of 2 Sessions
Presenter of 5 Presentations
Q&A (ID 2031)
MANAGING GORD IN ESOPHAGEAL ATRESIA PATIENTS: A GOOD IDEA? (ID 1557)
Weaning from enteral nutrition: who, when and how (ID 2028)
Welcome Introduction (ID 2027)
G-O013 - COMPLICATIONS OF ONE-STEP BUTTON PERCUTANEOUS ENDOSCOPIC GASTROSTOMY IN CHILDREN (ID 202)
Abstract
Objectives and Study
One step button per endoscopic gastrostomy (B-PEG) has become increasingly used in children but large series addressing complications on a long follow-up are missing. To assess the complications of one-step button percutaneous endoscopic gastrostomy (B-PEG) and determine risk factors for developing stomal infections or gastropexy complications.
Methods
A retrospective study of 679 children who underwent a B-PEG procedure in a single tertiary care center over a 10-year period to December 2020 was conducted. Patient characteristics, early complications (occurring £7 days after the procedure), late complications (>7 days after the procedure), and outcomes were collected from medical records. A list of potential risk factors, including age at procedure, prematurity, underlying neurological disease, and undernutrition, was determined a priori.
Results
At least 1 year of follow-up was available for 513 patients. Median follow-up duration was 2.8 years (interquartile range 1.0–4.9 years). Major complications were rare (<2%), and no death was related to B-PEG. Early complications affected 15.9% of the study population, and 78.0% of children presented late complications. Development of granulation tissue was the most common complication followed in frequency by tube dislodgment and T-fastener complications. Only 24 patients (3.5%) presented stomal infections. Young age at the time of PEG placement (odds ratio (OR) 2.34 [1.03–5.30], p = .042) and prematurity (OR 2.54 [1.10 – 5.83], p = 0.029) were risks factor for developing peristomal infection. T-fastener migration occurred in 17.3% of children, and we found underlying neurological disease was a protective factor (OR 0.59 [0.37–0.92], p = .019).
Conclusions
B-PEG is a safe method and associated with a low rate of local infection. However, T-fasteners are associated with significant morbidity and require particular attention in young and premature infants.