Long-Term Outcome of Children Receiving Percutaneous Endoscopic Gastrostomy Feeding

Objectives: The aim of the present study was to analyze the long-term follow-up of children receiving percutaneous endoscopic gastrostomy (PEG) in terms of survival, nutritional outcome, and weaning from enteral nutrition. The secondary objectives were to evaluate the complications related to PEG and the outcome of patients with neurological disability. Methods: The present study was a single-center retrospective study including all of the 368 patients who underwent PEG from 1990 to 2003 in our tertiary hospital. Results: A total of 368 patients received PEG during the study period. After a median follow-up of 2.4 years (interquartile range 1.4-4.2 years), PEG was in place in 36% and was removed in 27%; 26% of patients were deceased. Two deaths could be directly related to PEG. A statistically significant weight and height catch-up was observed in patients with PEG in place in whom weight/age z score increased from -2.6 to -1.7 (P<0.01) and height/age z score also increased from -2.1 to -1.6 (P<0.01). In patients who had their PEG removed weight/age z score increased from -2.5 to -1.6 (P<0.01) and height/age z score from 2.8 to 1.4 (P = 0.01) at the time of weaning. Early complications occurred in 152 patients, whereas late complications occurred in 191 patients. Most complications were minor (85%). After multivariate analyses, the factors associated with late complications were digestive and ear, nose, and throat (ENT) diseases, age <1 year at the time of PEG placement, and use of PEG longer than 2 years. Early complications were less frequent in patients with respiratory diseases. Conclusions: PEG allows nutritional and growth catch-up and is safe in the long term.