Shin Miyata1, Fanglong Dong2, Olga Lebedevskiy3, Hanna Park4, Nam Nguyen5. 1. Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, United States; Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, United States. Electronic address: drmiyatas@gmail.com. 2. Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, United States. Electronic address: fdong@westernu.edu. 3. Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, United States; Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, United States. Electronic address: olga.lebedevskiy@gmail.com. 4. Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, United States. Electronic address: hanna.s.park@gmail.com. 5. Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, United States. Electronic address: nanguyen@chla.usc.edu.
Abstract
PURPOSE: Safety profile of different gastrostomy procedures in small children has not been well studied. This study was conducted to investigate whether complication and mortality rates differ between surgical gastrostomy (G-tube) and percutaneous endoscopic gastrostomy (PEG) in infants and neonates. METHODS: In this retrospective study utilizing the Kids' Inpatient Database, all infants who underwent either G-tube or PEG as a sole procedure were identified. Variables included age, gender, race, presence of neurological impairment, prematurity, complex chronic condition, and severity of illness/risk of mortality subclasses. Postoperative complication, reoperation, and mortality rates were compared between G-tube and PEG. A subgroup of neonates was also analyzed. RESULTS: A total of 1456 infants were identified (G-tube n=874, PEG n=582). In univariate analysis, the rates of adverse outcomes were not significantly different (G-tube vs PEG complication rate was 7.3% and 6.7%, p=0.65; mortality rate 1.3% and 0.7%, p=0.29, respectively). Adjusted odds ratios (ORs) for complication were 1.07 (G-tube vs PEG, 95% confidence interval [CI] 0.700-1.620) for overall infants and 1.19 (95% CI 0.601-2.350) for the neonatal subgroup. Similarly, adjusted ORs for mortality did not differ significantly both in infants (OR 1.749, 95% CI 0.532-5.755) and in the neonatal subgroup (OR 2.153, 95% CI 0.566-8.165). CONCLUSIONS: When G-tube and PEG were performed as the only procedure throughout a hospitalization in infants and neonates, the two techniques had comparable risks of postoperative complications and mortalities. LEVEL OF EVIDENCE: Retrospective comparative study, Level III.
PURPOSE: Safety profile of different gastrostomy procedures in small children has not been well studied. This study was conducted to investigate whether complication and mortality rates differ between surgical gastrostomy (G-tube) and percutaneous endoscopic gastrostomy (PEG) in infants and neonates. METHODS: In this retrospective study utilizing the Kids' Inpatient Database, all infants who underwent either G-tube or PEG as a sole procedure were identified. Variables included age, gender, race, presence of neurological impairment, prematurity, complex chronic condition, and severity of illness/risk of mortality subclasses. Postoperative complication, reoperation, and mortality rates were compared between G-tube and PEG. A subgroup of neonates was also analyzed. RESULTS: A total of 1456 infants were identified (G-tube n=874, PEG n=582). In univariate analysis, the rates of adverse outcomes were not significantly different (G-tube vs PEG complication rate was 7.3% and 6.7%, p=0.65; mortality rate 1.3% and 0.7%, p=0.29, respectively). Adjusted odds ratios (ORs) for complication were 1.07 (G-tube vs PEG, 95% confidence interval [CI] 0.700-1.620) for overall infants and 1.19 (95% CI 0.601-2.350) for the neonatal subgroup. Similarly, adjusted ORs for mortality did not differ significantly both in infants (OR 1.749, 95% CI 0.532-5.755) and in the neonatal subgroup (OR 2.153, 95% CI 0.566-8.165). CONCLUSIONS: When G-tube and PEG were performed as the only procedure throughout a hospitalization in infants and neonates, the two techniques had comparable risks of postoperative complications and mortalities. LEVEL OF EVIDENCE: Retrospective comparative study, Level III.
Authors: Ayman Goneidy; Stuart Wilkinson; Omendra Narayan; David John Wilkinson; Nick Lansdale; Robert Thomas Peters Journal: Pediatr Surg Int Date: 2022-02-17 Impact factor: 1.827
Authors: Fayza Haider; Hasan Mohamed Ali Isa; Mohamed Amin Al Awadhi; Barrak Ayoub; Ezat Bakhsh; Husain Al Aradi; Shahraban Abdulla Juma Journal: Int J Pediatr Date: 2020-10-08
Authors: Erin F Carlton; John P Donnelly; Matthew K Hensley; Timothy T Cornell; Hallie C Prescott Journal: Crit Care Med Date: 2020-05 Impact factor: 7.598
Authors: Joanne M Lagatta; Michael Uhing; Krishna Acharya; Julie Lavoie; Erin Rholl; Kathryn Malin; Margaret Malnory; Jonathan Leuthner; David C Brousseau Journal: J Pediatr Date: 2021-03-28 Impact factor: 6.314
Authors: L Dupree Hatch; Theresa A Scott; William F Walsh; Adam B Goldin; Martin L Blakely; Stephen W Patrick Journal: J Perinatol Date: 2018-06-21 Impact factor: 2.521