Nationwide Survey for Pediatric Gastrostomy Tube Placement in Korea

Abstract

Background Various methods have been implemented for pediatric gastrostomy tube placement. We aimed to investigate the performance status of pediatric gastrostomy in South Korea and to present indications and appropriate methods for domestic situations. Methods A survey was conducted among pediatric endoscopists who performed upper gastrointestinal endoscopy in Korea. The questionnaire consisted of 16 questions on gastrostomy performance status. Results Among the 48 institutions where the survey was applied, 36 (75%) responded. Of the 36 institutions, gastrostomy was performed in 31 (86.1%). The departments in which gastrostomy was performed were pediatrics at 26 institutions (81.3%), surgery at 24 institutions (75.0%), internal medicine at 9 institutions (28.1%), and radiology at 7 institutions (21.9%). There were 18 institutions (66.7%) using the pull method for percutaneous endoscopic gastrostomy (PEG) and nine institutions (33.3%) using the push method. When performing gastrostomies, fundoplication procedures were performed in 19 institutions (61.3%), if deemed necessary. However, 12 institutions (38.7%) answered that gastrostomy was always implemented alone. Complications after gastrostomy included buried bumper syndrome, wound infection, leakage, tube migration, and incorrect opening site in the stomach, but the number of cases with complications was very small. Conclusion In Korea, a pediatric gastrostomy is implemented in various ways depending on the institution. Clinicians are concerned about choosing the most effective methods with fewer complications after the procedure. In our study, we reported only a few complications. Korea has good accessibility for pediatric gastrointestinal endoscopy, and this survey showed that it is a safe procedure that can be considered initially in pediatric gastrostomy. This study is expected to help to create optimal pediatric PEG guidelines in Korea.

Pediatric Percutaneous Endoscopic Gastrostomy in Korea - When? By Whom? How?

“…In Korea, the involvement of pediatric gastroenterologist is even higher (80.6% vs 37.7%), however mostly (58.1%) collaboratively performed with other specialists and this might be somehow desirable because multidisciplinary team approach is recommended in the course of PEG placement. 4 …”

“…Lee et al 4 surveyed pediatric PEG status at 36 institutions in Korea. They reported 31 (86.1%) institutions performed PEG; 26 at Department of Pediatrics, 24 at Department of Surgery, 9 at Department of Internal Medicine, and 7 at Department of Radiology.…”

“…Complications after gastrostomy included buried bumper syndrome, wound infection, leakage, tube migration, and incorrect opening site in the stomach, but the number of cases with complications was very small. 4 The procedure is limited in some institutions but common and safe in Korea.…”