PURPOSE: We aimed to evaluate the rate and examine potential predictors of subsequent anti-reflux procedures in a population undergoing percutaneous endoscopic gastrostomy (PEG) insertion. MATERIALS: We retrospectively reviewed the pre- and post-operative clinical course of patients undergoing PEG insertion over a 10-year period with respect to indication, underlying co-morbidity, and GER investigation and management. RESULTS: We reviewed data on 170 patients. Neurological disability (e.g., cerebral palsy) was the most common underlying condition in those undergoing PEG insertion (n = 104) followed by cystic fibrosis (n = 29). Oropharyngeal dysphagia and failure to thrive were the commonest indications for PEG. Eight patients (4.7%) reported increased frequency of vomiting after PEG, 6 (75%) of whom had a pre-operative diagnosis of GER. Two (25%) patients from this sub-group subsequently required anti-reflux surgery. Patient's with neurological disease were not at increased risk of new-onset GER or increased vomiting following PEG insertion compared to those with non-neurological conditions (p = 0.259). In total, 8 (4.7%) and 7 (4.1%) patients underwent fundoplication and gastrojejunal tube insertion, respectively. CONCLUSIONS: PEG insertion does not appear to induce symptomatic gastro-oesophageal reflux in the majority of children, suggesting that in the majority of cases, a concurrent anti-reflux procedure is unnecessary. Parents should be counseled accordingly.
PURPOSE: We aimed to evaluate the rate and examine potential predictors of subsequent anti-reflux procedures in a population undergoing percutaneous endoscopic gastrostomy (PEG) insertion. MATERIALS: We retrospectively reviewed the pre- and post-operative clinical course of patients undergoing PEG insertion over a 10-year period with respect to indication, underlying co-morbidity, and GER investigation and management. RESULTS: We reviewed data on 170 patients. Neurological disability (e.g., cerebral palsy) was the most common underlying condition in those undergoing PEG insertion (n = 104) followed by cystic fibrosis (n = 29). Oropharyngeal dysphagia and failure to thrive were the commonest indications for PEG. Eight patients (4.7%) reported increased frequency of vomiting after PEG, 6 (75%) of whom had a pre-operative diagnosis of GER. Two (25%) patients from this sub-group subsequently required anti-reflux surgery. Patient's with neurological disease were not at increased risk of new-onset GER or increased vomiting following PEG insertion compared to those with non-neurological conditions (p = 0.259). In total, 8 (4.7%) and 7 (4.1%) patients underwent fundoplication and gastrojejunal tube insertion, respectively. CONCLUSIONS:PEG insertion does not appear to induce symptomatic gastro-oesophageal reflux in the majority of children, suggesting that in the majority of cases, a concurrent anti-reflux procedure is unnecessary. Parents should be counseled accordingly.
Authors: Elizabeth D Ferluga; Nila A Sathe; Shanthi Krishnaswami; Melissa L Mcpheeters Journal: Dev Med Child Neurol Date: 2013-06-05 Impact factor: 5.449
Authors: S Van Biervliet; K Van Renterghem; D Vande Putte; S Vande Velde; R De Bruyne; M Van Winckel Journal: Acta Gastroenterol Belg Date: 2014-03 Impact factor: 1.316
Authors: Marta King; Douglas C Barnhart; Molly O'Gorman; Earl C Downey; Daniel Jackson; Michael Mundorff; Richard Holubkov; Peter Feola; Rajendu Srivastava Journal: J Pediatr Gastroenterol Nutr Date: 2014-04 Impact factor: 2.839
Authors: Todd A Ponsky; Alessandra C Gasior; Jennifer Parry; Susan W Sharp; Scott Boulanger; Robert Parry; Daniel J Ostlie; Shawn D St Peter Journal: J Surg Res Date: 2012-04-18 Impact factor: 2.192