Abstract
Background and study aims Insertion of a percutaneous endoscopic gastrostomy (PEG) with push-through technique
and T-fastener fixation (PEG-T) has recently been introduced in pediatric patients.
The T-fasteners allow a primary insertion of a balloon gastrostomy. Due to limited
data on the results of this technique in children, we have investigated peri- and
postoperative outcomes after implementation of PEG-T in our department.
Patients and methods This retrospective chart review included all patients below 18 years who underwent
PEG-T placement from 2010 to 2014. Main outcomes were 30-day postoperative complications
and late gastrostomy-related complications.
Results In total, 87 patients were included, and median follow-up time was 2.4 years (1 month
– 4.9 years). Median age and weight at PEG-T insertion were 1.9 years (9.4 months
– 16.4 years) and 10.4 kg (5.4 – 33.0 kg), respectively. Median operation time was
28 minutes (10 – 65 minutes), and 6 surgeons and 3 endoscopists performed the procedures.
During the first 30 days, 54 complications occurred in 41 patients (47 %). Most common
were peristomal infections treated with either local antibiotics in 11 patients (13 %)
or systemic antibiotics in 11 other patients (13 %). 9 patients (10 %) experienced
tube dislodgment. Late gastrostomy-related complications occurred in 33 patients (38 %).
The T-fasteners caused early and late complications in 9 (10 %) and 11 patients (13 %),
respectively. Of these, 4 patients (5 %) had subcutaneously migrated T-fasteners which
were removed under general anesthesia.
Conclusion We found a high rate of complications after PEG-T. In particular, problems with the
T-fasteners and tube dislodgment occurred frequently after PEG-T insertion.
