Complications and clinical factors associated with pediatric percutaneous endoscopic gastrostomy in a Colombian cohort.

INTRODUCTION

Malnutrition significantly impairs both physical and cognitive function, increasing the risk of morbidity and mortality, especially in patients lacking a safe and effective route for enteral nutrition. Percutaneous endoscopic gastrostomy offers a minimally invasive solution for long-term enteral nutrition in pediatric patients, with a lower risk of perioperative complications compared to surgical alternatives.

OBJECTIVE

To evaluate the frequency, timing, and clinical factors associated with postoperative complications following pediatric percutaneous endoscopic gastrostomy.

METHODS

A retrospective analytical cohort study was conducted, including pediatric patients (≤18 years) who underwent Percutaneous endoscopic gastrostomy placement between January 2018 and December 2024. Bivariate analyses and Kaplan-Meier survival curves were used to assess the frequency of complications and complication-free survival time.

RESULTS

A total of 86 pediatric patients underwent Percutaneous endoscopic gastrostomy during the study period, of whom 12 (14%) experienced major postoperative complications. The median age was 4.53 years (interquartile range: 1.56-9.46 years). The most frequent major complication was Buried Bumper Syndrome, observed in 9 patients (10.47%). Minor complications included mild peristomal infection (8.14%) and feeding intolerance (5.81%). A complication-free survival of 96.73% (95% CI: 87.26-99.19) by day 12 and 69.35% (95% CI: 45.33-84.43) by day 40 was determined.

DISCUSSION

This study underscores the importance of systematic nutritional assessment and optimized post-operative care to reduce complications following PEG in pediatric patients. The high incidence of Buried Bumper Syndrome calls for more stringent follow-up protocols, especially in resource-limited settings. Close monitoring during the early post-operative period can prevent complications.