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一步经皮内镜胃造口术(推式 PEG)按钮在儿科患者中的安全性。

Safety of the One Step Percutaneous Endoscopic Gastrostomy (Push-PEG) Button in Pediatric Patients.

机构信息

From the Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.

出版信息

J Pediatr Gastroenterol Nutr. 2023 Dec 1;77(6):828-834. doi: 10.1097/MPG.0000000000003930. Epub 2023 Aug 23.

Abstract

OBJECTIVES

Percutaneous endoscopic gastrostomy (PEG)-systems are essential tools for enteral feeding in a broad variety of pediatric patients. The One Step ("Push-PEG") technique allows the direct introduction of a PEG-Button. The aim of the study was to investigate the safety and parental view of the Push-PEG technique.

METHODS

We conducted a single-center retrospective data and questionnaire (SDC, http://links.lww.com/MPG/D296 ) based study including all pediatric patients receiving a PEG via push or pull technique between 2015 until end of 2020 and compared these 2 groups. The primary outcome was the detection of minor and major complications. Secondary outcomes were growth, thriving, and parental contentment using a Likert-scaled questionnaire.

RESULTS

Eighty-three patients were included in the analysis. There were no significant differences in the basic data regarding age, weight, or diagnosis category. Overall complication rate was 34.9%. The Push-PEG group showed a lower rate of complications (32.7% vs 38.7%) and a lower rate of major complications (4.1% vs 8.8%), although the difference is not significant. Thirty-four families completed the questionnaire (SDC, http://links.lww.com/MPG/D296 ) (response rate 40%). There were no significant differences between the 2 groups regarding answers of the Likert-scaled questions.

CONCLUSION

Push-PEG placement seems to be as safe as placement via traditional pull technique, even in small infants more than 2.8 months and 4 kg. As Push-PEG placement requires less follow-up interventions it may show significant advantages and could be the method of first choice in many cases.

摘要

目的

经皮内镜胃造口术(PEG)系统是各种儿科患者进行肠内喂养的重要工具。一步法(Push-PEG)技术可直接引入 PEG-Button。本研究旨在探讨 Push-PEG 技术的安全性和家长看法。

方法

我们进行了一项单中心回顾性数据和问卷调查(SDC,http://links.lww.com/MPG/D296)研究,纳入了 2015 年至 2020 年底期间所有通过推或拉技术接受 PEG 的儿科患者,并比较了这两组。主要结局是检测轻微和严重并发症。次要结局是使用李克特量表问卷调查生长、茁壮和家长满意度。

结果

83 例患者纳入分析。年龄、体重或诊断类别等基本数据无显著差异。总体并发症发生率为 34.9%。推式 PEG 组并发症发生率较低(32.7% vs. 38.7%),严重并发症发生率较低(4.1% vs. 8.8%),但差异无统计学意义。34 个家庭完成了问卷调查(SDC,http://links.lww.com/MPG/D296)(应答率 40%)。两组在李克特量表问题的答案方面无显著差异。

结论

推式 PEG 放置似乎与传统的拉式技术一样安全,即使是 2 个多月和 4kg 以上的小婴儿。由于推式 PEG 放置需要较少的随访干预,它可能具有显著的优势,并且在许多情况下可能是首选方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b24/10642703/68bb832486d8/mpg-77-0828-g001.jpg

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