Complications of percutaneous endoscopic gastrostomy in children: Results of an Italian multicenter observational study

Background: Percutaneous endoscopic gastrostomy is the preferred way to achieve an artificial feeding route for patients requiring long-term enteral nutrition. Although the procedure is well-standardized, it carries early and late complications. Aim: To establish the mortality and morbidity of this technique in a large cohort of children. Methods: A multi-centre prospective clinical data collection from children undergoing percutaneous endoscopic gastrostomy tube implantation has been conducted from January 2004 to December 2007. Previous abdominal surgery was the only exclusion criterion. Follow-up visits were carried out at 1, 3, 6, 12, and 24. months after the procedure. Results: 239 children (males, 55.2%; mean age 6.05 ± 6.1. years) were enrolled from nine tertiary Italian centres. Major complications occurred in 8 patients (3.3%). The cumulative incidence of complications was 47.7% at 24. months. The presence of thoraco-abdominal deformity was an independent predictor of complications at 12. months. No risk factors were identified in association to complications during the 1st tube replacement. Conclusion: In children undergoing percutaneous endoscopic gastrostomy placement minor complications are common, while severe morbidities are rare. Accurate follow up is essential to recognize every complication, in particular when risk factors such as thoraco-abdominal deformity exist.