Comparison of operative outcomes between surgical gastrostomy and percutaneous endoscopic gastrostomy in infants

Miyata, Shin; Dong, Fanglong; Lebedevskiy, Olga; Park, Hanna; Nguyen, Nam X.

doi:10.1016/j.jpedsurg.2017.01.008

Cited by 24 publications

(14 citation statements)

References 27 publications

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“…Gastrostomy placement was identified using ICD-9-CM procedure codes 43.11 (Percutaneous [endoscopic] gastrostomy) and 43.19 (other gastrostomy). 18 We further classified infants according to whether they had received a fundoplication ( ICD-9-CM procedure codes 44.66 [other procedures for creation of esophagogastric sphincteric competence] and 44.67 [laparoscopic procedures for creation of esophagogastric sphincteric competence]) during the same hospitalization as their GT. 11 As Current Procedural Terminology (CPT) codes are not available in the KID, we used ICD-9-CM procedure codes alone to identify the procedures and thus could not reliably identify open versus laparoscopic GT.…”

Section: Methodsmentioning

confidence: 99%

National and regional trends in gastrostomy in very low birth weight infants in the USA: 2000–2012

et al. 2018

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Section: Methodsmentioning

confidence: 99%

National and regional trends in gastrostomy in very low birth weight infants in the USA: 2000–2012

et al. 2018

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“…No intra-operative complications or organ injuries were identified, although the authors acknowledged the potential limitation of their 90-day follow-up missing colonic injuries that might be identified later [9]. A prior study using the KID found that PEG and SG had similar risks of postoperative complications and mortality in relatively uncomplicated infants and neonates in whom gastrostomy was the only procedure performed [10]. PEG has the benefit of generally shorter operative time than SG.…”

Section: Discussionmentioning

confidence: 96%

Variability in the Method of Gastrostomy Placement in Children

et al. 2020

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Although gastrostomy placement is one of the most common procedures performed in children, the optimal technique remains unclear. The purpose of this study was to evaluate variability in the method of gastrostomy tube placement in children in the United States. Patients <18 years old undergoing percutaneous endoscopic gastrostomy (PEG) or surgical gastrostomy (SG) (including open or laparoscopic) from 1997 to 2012 were identified using the Kids’ Inpatient Database. Method of gastrostomy placement was evaluated using a multivariable mixed-effects logistic regression model with a random intercept term and a patient-age random-effect term. A total of 67,811 gastrostomy placements were performed during the study period. PEG was used in 36.6% of entries overall and was generally consistent over time. PEG placement was less commonly performed in infants (adjusted odds ratio [aOR] 0.30, 95%CI 0.26–0.33), children at urban hospitals (aOR: 0.38, 95%CI 0.18–0.82), and children cared for at children’s hospitals (aOR 0.57, 95%CI 0.48–0.69) and was more commonly performed in children with private insurance (aOR 1.17, 95%CI 1.09–1.25). Dramatic variability in PEG use was identified between centers, ranging from 0% to 100%. The random intercept and slope terms significantly improved the model, confirming significant center-level variability and increased variability among patients <1 year old. These findings emphasize the need to further evaluate the safest method of gastrostomy placement in children, in particular among the youngest patients in whom practice varies the most.

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“…The PEG technique offered the advantage of scar-less operation with a shorter time in the operating room [ 3 ]. When performed in relatively uncomplicated infants or neonates where gastrostomy is the only procedure performed, PEG has similar risks of postoperative complications as compared to the surgical G-tube [ 8 ]. Once PEG was available in our center, 20% of the cases received this tube type insertion that was later removed and changed to button tube.…”

Section: Discussionmentioning

confidence: 99%

Button Gastrostomy Tubes for Pediatric Patients: A Tertiary Care Center Experience

Haider

Isa

Awadhi

et al. 2020

International Journal of Pediatrics

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Background and Objective. Gastrostomy tube insertion is one of the most common procedures performed as a radical choice to overcome feeding difficulty in children. This study is aimed at describing the replacement of a button tube instead of the long tube for feeding infants and children requiring gastrostomies in a tertiary care hospital. Design and Setting. This retrospective cross-sectional descriptive study was conducted between January 2009 and August 2019 at Salmaniya Medical Complex which is a tertiary health care institute in the Kingdom of Bahrain. Subjects and Methods. Both charts and electronic health records of pediatric patients between the ages of 0 and 14 years were reviewed. Data were collected including age, sex, nationality, diagnosis, surgical information (procedure center and procedure performed), complications, and follow-up. Results. Out of 34 patients who underwent gastrostomy tube insertion, 30 patients had their long tube replaced by a button gastrostomy. Majority were males (N=18, 60%). Prolonged nasogastric tube feeding was the main indication of referral (N=17, 56%) followed by feed intolerance (N=6, 17%) and gastroesophageal reflux disease (N=5, 16%). The main underlying diseases at referral were neurological impairment (N=19, 63%) and metabolic disorders (N=4, 13%). There was no significant difference between patients with neurological disorders and other diseases in terms of gender, nationality, or age. Laparotomy with gastrostomy is the main approach used (N=18, 60%). No reported complications of button tubes in 50% of the patients (N=15). Conclusions. Prolonged nasogastric tube feeding is the main indication of referral for gastrostomy tube insertion. Neurological disorders are the main diagnosis for the cases operated upon. Laparotomy with gastrostomy is the procedure of choice at our center. Majority of patients had no reported complications of button tube replacement. These children are likely to benefit from the button tube with fewer complications.

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Comparison of operative outcomes between surgical gastrostomy and percutaneous endoscopic gastrostomy in infants

Cited by 24 publications

References 27 publications

National and regional trends in gastrostomy in very low birth weight infants in the USA: 2000–2012

National and regional trends in gastrostomy in very low birth weight infants in the USA: 2000–2012

Variability in the Method of Gastrostomy Placement in Children

Button Gastrostomy Tubes for Pediatric Patients: A Tertiary Care Center Experience

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