COMPLICATIONS OF REMOVING PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TUBES IN CHILDREN

Abstract

118 Objective: To determine the frequency and type of complications arising from removal of percutaneous endoscopic gastrostomy (PEG) tubes in children. Methods: The records of 397 patients having PEG tubes placed between 1993 and 1998 were reviewed for any complications after removal. Removal of the feeding tube was based on clinical assessment of the patients feeding ability. Data collected included, the type of complication, length of time the tube was in place, age of the patient at insertion, type of feeding tube removed, and indication for placement. Results: 54 children had their PEG tubes removed using either the traction technique or via Endoscopy. The only complication was a persistent gastrocutaneous fistula requiring surgical intervention, 7 patients (13%). Comparison of these 7 children to those not requiring surgery showed longer duration of tube placement (20 ± 3.6 months, range 11-21 months vs. 11.1 ± 1.3 months, range 1-35 months; p< 0.05). Age at insertion, type of tube removed, and underlying disease status were not different between the two groups. Conclusions: Our experience indicates that patients with a PEG tube in place for longer than 11 months have a significantly higher chance of developing a gastrocutaneous fistula with persistent leakage requiring surgical intervention. In patients identified as candidates for tube removal, this time frame may be important in clinical decision making.