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Long-term Outcomes of Infants and Children Undergoing Percutaneous Endoscopy Gastrostomy Tube Placement

McSweeney, Maireade E.; Jiang, Hongyu; Deutsch, Amanda J.; Atmadja, Melissa; Lightdale, Jenifer R.

Journal of Pediatric Gastroenterology & Nutrition: November 2013 - Volume 57 - Issue 5 - p 663–667
doi: 10.1097/MPG.0b013e3182a02624
Original Articles: Hepatology and Nutrition

Objectives: Little is known about long-term outcomes of patients undergoing percutaneous endoscopic gastrostomy (PEG) placement. The purpose of this study was to examine tube-related major complications in pediatric patients undergoing PEG placement during a 10-year follow-up period.

Methods: A retrospective chart review of patients undergoing PEG placement from April 1999 through December 2000 at Boston Children's Hospital was performed. Cumulative incident rates of major complications (defined by additional hospitalization, surgical or interventional radiology procedures) as well as time between PEG placement and major complications were evaluated using Kaplan-Meier survival analysis. Time to elective tube removal and patient mortality was also assessed.

Results: One hundred thirty-eight patients (59% [n = 82] boys [median age 22.5 months] [interquartile range, IQR 9–72.5], weight 9.2 kg [IQR 6.1–15.8]), underwent PEG placement during the study period and were followed at our hospital for a median of 4.98 years (IQR 1.5–8.7) years. Median time to elective tube removal was 10.2 years, with approximately half of the patients estimated to still have an indwelling enteral tube 10 years after placement. Fifteen patients (11%) had at least 1 major complication related to their gastrostomy tubes during the examined time period. The cumulative incidence of patients having a major complication was 15% (95% confidence interval 8.9–24.5) by 5.4 years.

Conclusions: Children undergoing PEG placement have a long-term high risk of morbidity related to enteral tubes. Major complications can occur many years after PEG placement. Larger prospective studies may be useful to assess risk factors for PEG-related complications in pediatrics.

Department of Medicine, Division of Gastroenterology, Boston Children's Hospital, Harvard Medical School, Boston, MA.

Address correspondence and reprint requests to Maireade E. McSweeney, MD, MPH, Division of Gastroenterology and Nutrition, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115 (e-mail: maireade.mcsweeney@childrens.harvard.edu).

Received 13 February, 2013

Accepted 7 June, 2013

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The authors report no conflicts of interest.

© 2013 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,