Objectives: The preferred method for providing long-term enteral nutrition in children is done by insertion of percutaneous endoscopic gastrostomy (PEG), known as pull-PEG, which can be replaced by a gastrostomy button after 12 weeks. Recently, a new method has been designed to perform a button gastrostomy in a one-step procedure (PEG-B). This technique offers advantages over classical pull-PEG especially in high-risk patients. Our aim is to describe our experience with one-step (PEG-B) procedure in children.
Methods: A retrospective review of children who underwent a PEG-B during the years 2012-2015. Demographic data, procedure indications, feeding initiation, duration of hospital stay and complications were recorded.
Results: 17 patients, aged 6 months to 35 years (mean 15±11) were included. Indications for PEG insertion were partial feeding support and complete need for enteral feeding. The size and length of the buttons were individually adjusted. Feeding through PEG was initiated within 12-36 hours of insertion. No major procedure-related complications were recorded within six months of follow up. One child died eight days after the procedure due to an unrelated tracheostomy complication. In one patient the 3 “buttons”, sutures of gastropexy, fell one day after the procedure and the use of PEG was delayed.
Conclusions: The one step (PEG-B) procedure was feasible and safe in children in this small series. The results are comparable to published results on the pull-PEG literature. Thus, the one-step method is advantageous in high-risk patients as it involves a single procedure and reduces the patient’s exposure to anesthesia.
