Percutaneous endoscopic gastrostomy in pediatric patients: Experience of 201 cases in a tertiary-care hospital

Background: Percutaneous endoscopic gastrostomy (PEG) has become a common technique for children who require long-term enteral feeding. The use of PEG can improve nutritional status of patients and widely accepted by caregivers. The present study revealed outcome of PEG in 201 children age <19 years performed by pediatric gastroenterologists in a tertiary-care hospital in Thailand. Materials and Methods: We retrospectively reviewed PEG registry of our division and medical records of pediatric patients (age <19 years) who underwent PEG at Division of Gastroenterology, Department of Pediatrics, Ramathibodi Hospital from January 2001 to December 2013. Results: Eighty-three percent of patients were neurologically impaired. The median weight was 9 kg (IQR 5.9 to 15.3) with a minimal weight of 2.9 kg; 50% were underweight (weight for age Z-score less than -2 standard deviation) at time of PEG. Overall, rate of early post-operative complications was 20%. Most of them were minor complications albeit 1.5% were major complications. There was no mortality. At 1-year follow-up, nutritional status improved significantly. Mean weight for age Z-score was -2.13+2.1 before PEG insertion and -1.38+1.9 at 1 year later (p = 0.0001). The proportion of underweight patients decreased from 45.3% to 39.7%. Median increased weight was 38.9% (IQR 19.5 to 65.9). Conclusion: PEG is a safe procedure for children, even in small infants, requiring long-term enteral feeding due to its favorable outcomes in terms of better nutritional status and the low rate of major complications.