Complications after pediatric percutaneous endoscopic gastrostomy: comparison of the push and pull technique

Purpose Various complications are associated with percutaneous endoscopic gastrostomy (PEG) procedures in children. The push technique is being increasingly used, but its complications are insufficiently characterized. We aimed to assess all complications related to PEG procedures and compare the sa...

Full description

Bibliographic Details
Main Authors: Reija Autio, Topi Luoto, Mona Takalo, Tarja Iber
Format: Article
Language:English
Published: BMJ Publishing Group 2024-03-01
Series:World Journal of Pediatric Surgery
Online Access:https://wjps.bmj.com/content/7/1/e000687.full
_version_ 1797229171825442816
author Reija Autio
Topi Luoto
Mona Takalo
Tarja Iber
author_facet Reija Autio
Topi Luoto
Mona Takalo
Tarja Iber
author_sort Reija Autio
collection DOAJ
description Purpose Various complications are associated with percutaneous endoscopic gastrostomy (PEG) procedures in children. The push technique is being increasingly used, but its complications are insufficiently characterized. We aimed to assess all complications related to PEG procedures and compare the safety of the pull and push techniques.Methods Retrospective review of consecutive pediatric patients who underwent PEG between 2002 and 2020.Results In total, 216 children underwent 217 PEG procedures. The push technique was used in 138 (64%) cases, and the pull technique in 79 (36%) cases. The median follow-up time was 6.1 (0.1–18.3) years. The complication rate was high (57%) and patients experienced complications years after the procedure. Overall, 51% and 67% of patients experienced complications in the push and pull groups, respectively. The rates of minor and major complications were higher in the pull group than in the push group (63% vs 48%, p=0.028; and 11% vs 6%, p=0.140, respectively). Reoperation was also more common in the pull group (17% vs 7%, p=0.020).Conclusions The overall complication rate of PEG procedures is high. Fortunately, most complications are mild and do not require reoperations. The increasing push technique appears to be safer than the traditional pull technique. Significant long-term morbidity is related to gastrostomies in children.
first_indexed 2024-03-08T10:11:37Z
format Article
id doaj.art-4418c4aa456d449bb165e41ca426c161
institution Directory Open Access Journal
issn 2516-5410
language English
last_indexed 2024-04-24T15:08:21Z
publishDate 2024-03-01
publisher BMJ Publishing Group
record_format Article
series World Journal of Pediatric Surgery
spelling doaj.art-4418c4aa456d449bb165e41ca426c1612024-04-02T12:20:09ZengBMJ Publishing GroupWorld Journal of Pediatric Surgery2516-54102024-03-017110.1136/wjps-2023-000687Complications after pediatric percutaneous endoscopic gastrostomy: comparison of the push and pull techniqueReija Autio0Topi Luoto1Mona Takalo2Tarja Iber3Faculty of Social Sciences, Tampere University, Tampere, FinlandDepartment of Pediatric Surgery, Tampere University Hospital, Tampere, FinlandFaculty of Medicine and Health Technology, Tampere University, Tampere, FinlandDepartment of Pediatric Surgery, Tampere University Hospital, Tampere, FinlandPurpose Various complications are associated with percutaneous endoscopic gastrostomy (PEG) procedures in children. The push technique is being increasingly used, but its complications are insufficiently characterized. We aimed to assess all complications related to PEG procedures and compare the safety of the pull and push techniques.Methods Retrospective review of consecutive pediatric patients who underwent PEG between 2002 and 2020.Results In total, 216 children underwent 217 PEG procedures. The push technique was used in 138 (64%) cases, and the pull technique in 79 (36%) cases. The median follow-up time was 6.1 (0.1–18.3) years. The complication rate was high (57%) and patients experienced complications years after the procedure. Overall, 51% and 67% of patients experienced complications in the push and pull groups, respectively. The rates of minor and major complications were higher in the pull group than in the push group (63% vs 48%, p=0.028; and 11% vs 6%, p=0.140, respectively). Reoperation was also more common in the pull group (17% vs 7%, p=0.020).Conclusions The overall complication rate of PEG procedures is high. Fortunately, most complications are mild and do not require reoperations. The increasing push technique appears to be safer than the traditional pull technique. Significant long-term morbidity is related to gastrostomies in children.https://wjps.bmj.com/content/7/1/e000687.full
spellingShingle Reija Autio
Topi Luoto
Mona Takalo
Tarja Iber
Complications after pediatric percutaneous endoscopic gastrostomy: comparison of the push and pull technique
World Journal of Pediatric Surgery
title Complications after pediatric percutaneous endoscopic gastrostomy: comparison of the push and pull technique
title_full Complications after pediatric percutaneous endoscopic gastrostomy: comparison of the push and pull technique
title_fullStr Complications after pediatric percutaneous endoscopic gastrostomy: comparison of the push and pull technique
title_full_unstemmed Complications after pediatric percutaneous endoscopic gastrostomy: comparison of the push and pull technique
title_short Complications after pediatric percutaneous endoscopic gastrostomy: comparison of the push and pull technique
title_sort complications after pediatric percutaneous endoscopic gastrostomy comparison of the push and pull technique
url https://wjps.bmj.com/content/7/1/e000687.full
work_keys_str_mv AT reijaautio complicationsafterpediatricpercutaneousendoscopicgastrostomycomparisonofthepushandpulltechnique
AT topiluoto complicationsafterpediatricpercutaneousendoscopicgastrostomycomparisonofthepushandpulltechnique
AT monatakalo complicationsafterpediatricpercutaneousendoscopicgastrostomycomparisonofthepushandpulltechnique
AT tarjaiber complicationsafterpediatricpercutaneousendoscopicgastrostomycomparisonofthepushandpulltechnique