Grayeb Mahmood, Lahad Avishay, Elhaj Rana, Elias Marwan, Shmaya Yael, Rinawi Firas
The Azrieli Faculty of Medicine, Bar-Ilan University, 8 Henrietta Szold St, POB 1589, Safed 1311502, Israel.
Pediatric Gastroenterology Unit, Emek Medical Centre, Afula 1834111, Israel.
Medicina (Kaunas). 2025 Feb 20;61(3):366. doi: 10.3390/medicina61030366.
: Data regarding long-term outcomes of gastrostomy-fed children is scarce. The aim of the study was to analyze the long-term follow-up of children receiving percutaneous endoscopic gastrostomy (PEG) in terms of nutritional outcomes, hospitalization, and fundoplication rates. : The medical records of gastrostomy-fed children who underwent PEG placement between January 2002 and June 2022 and subsequently attended primary care clinics of the Clalit Health Services (CHS) in Northeastern Israel, were reviewed in this retrospective cohort study. : A total of 372 gastrostomy tubes (GT) were placed, 88% of the children had neuro-developmental impairment. During the median follow-up of 64 months, 230 patients (62%) had frequent recurrent hospitalizations defined as at least two hospitalizations per year on average. Hospitalizations were due to respiratory infections in 52%. Among 322 patients who underwent iron status work-up, (64%) and (31%) had iron deficiency (ID) and ID anemia, respectively. Laboratory monitoring of other micronutrient levels was limited but showed that 25/73 (34%) had vitamin D deficiencies, without significant association with recurrent hospitalization ( > 0.1). A total of 12% of the patients underwent subsequent fundoplication. : This study confirmed the durability of gastrostomy tube feeding in children with neurological impairment, noting a low prevalence of fundoplication but a high rate of hospitalizations, primarily due to respiratory infections. Regular assessment of micronutrient deficiencies, particularly vitamin D, is recommended for these patients.
关于经胃造口喂养儿童的长期预后数据稀缺。本研究的目的是分析接受经皮内镜下胃造口术(PEG)儿童的长期随访情况,包括营养结局、住院情况和胃底折叠术发生率。
在这项回顾性队列研究中,对2002年1月至2022年6月期间接受PEG置管且随后在以色列东北部的克拉利特医疗服务机构(CHS)初级保健诊所就诊的经胃造口喂养儿童的病历进行了审查。
共放置了372根胃造口管(GT),88%的儿童有神经发育障碍。在64个月的中位随访期间,230名患者(62%)有频繁的反复住院情况,定义为平均每年至少住院两次。52%的住院原因是呼吸道感染。在322名接受铁状态检查的患者中,分别有64%和31%患有缺铁(ID)和缺铁性贫血。对其他微量营养素水平的实验室监测有限,但显示25/73(34%)有维生素D缺乏,与反复住院无显著关联(>0.1)。共有12%的患者随后接受了胃底折叠术。
本研究证实了胃造口管喂养在神经功能障碍儿童中的持久性,注意到胃底折叠术的患病率较低,但住院率较高,主要原因是呼吸道感染。建议对这些患者定期评估微量营养素缺乏情况,尤其是维生素D。