Should single-stage PEG buttons become the procedure of choice for PEG placement in children? - 16/08/11
Reprint requests: Jonathan S. Evans, MD, Division of Pediatric Gastroenterology and Nutrition, Nemours Children’s Clinic, 807 Child’s way, Jacksonville, FL 32207.Jacksonville, Florida, USA
Abstract |
Background |
Single-stage PEG buttons (PEG-B) allow initial placement of a skin-level gastrostomy device for children who require enteral access. They offer significant advantages over traditionally placed PEG tubes (PEG-T) but have not been widely accepted into practice.
Objective |
To review our experience with PEG-Bs compared with PEG-Ts.
Hypothesis |
PEG-B shares a similar safety profile with PEG-T but delays the need for an initial device change well beyond the change that usually occurs at 6 to 8 weeks after PEG-T placement.
Design |
Retrospective chart review.
Setting |
Nemours Children’s Clinic, Jacksonville, Florida.
Patients |
All children undergoing both PEG procedures and attending our clinic from 1997 to 2002.
Main Outcome Measurements |
Age, sex, weight, indications, postoperative complications, interval until first tube change and first tube change complications.
Results |
Totals of 145 and 93 patients were identified in the PEG-B and PEG-T groups, respectively. Patient characteristics were similar in the 2 groups with respect to age, weight, indications, and postoperative complications. The interval until first tube change, however, was significantly longer in the PEG-B group (314 days) than in the PEG-T (78 days) (P < .0001). In addition, the PEG-B was found to be as safe as the PEG-T for small infants who weighed less than 5 kg.
Conclusions |
PEG-B placement should be considered as the procedure of choice over PEG-T placement for children. It offers similar safety profiles, even for small patients and a significantly longer interval until first device change.
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| Presented as an abstract at the World Congress for Pediatric Gastroenterology and Nutrition, July 3-7, 2004, Paris, France (J Pediatr Gastroenterol Nutr 2004;39(Suppl):S334-5). See CME section; p. 390. |
Vol 64 - N° 3
P. 320-324 - settembre 2006 Ritorno al numero
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