Theme |
Gastrointestinal Endoscopy in Children |
Title |
Percutaneous Endoscopic Gastrostomy for Children |
Publish Date |
2015/03 |
Author |
Katsunari Takifuji |
Second Department of Surgery, Wakayama Medical University, School of Medicine |
Author |
Yasuyuki Mitani |
Second Department of Surgery, Wakayama Medical University, School of Medicine |
Author |
Takashi Watanabe |
Second Department of Surgery, Wakayama Medical University, School of Medicine |
Author |
Akio Kubota |
Second Department of Surgery, Wakayama Medical University, School of Medicine |
Author |
Hiroki Yamaue |
Second Department of Surgery, Wakayama Medical University, School of Medicine |
[ Summary ] |
Recently, percutaneous endoscopic gastrostomy (PEG) is considered a safe and minimally invasive procedure for pediatric patients who require enteral nutrition. Cases of pediatric patients who require PEG have severe neurological impairment and congenital myopathy, and often have severe scoliosis. Moreover, their physique is small, making it difficult simply to use an adult PEG kit and necessary to choose suitable devices tailored to the physique of children. Gastropexy was first performed with a percutaneous anchoring device under endoscopy because the pediatric gastric wall is soft and extends easily. A balloon‒type PEG tube is placed by the modified introducer technique because it is easy to change or remove a balloon‒type PEG tube in children. The modified introducer technique has no risk of infection from oral pathogens and no risk of injuries of the pharynx and esophagus by a PEG bumper. The average operative time is 25.3 minutes, and we have been able to begin feeding the patient 1.5 days after surgery. There have been no operative complications. PEG with a modified introducer technique combined with a percutaneous anchoring device is safe and useful for children. |