Short summary

Percutaneous endoscopic gastrostomy (PEG) is a widespread, surgically invasive, solution for enteral feeding in paediatric patients with a high risk of malnutrition due to nutrition problems of various reasons. To make the treatment safer we will perform a retrospective study with the aim to investigate the complication rates in paediatric patients who have received a PEG during the time period 2000 to 2012. Any complications within a follow-up period on a minimum of 36 months will be registered. Special focus will be on major complications, which are defined as death, need for re-operation, systemic antibiotics or/and need of blood transfusion. Minor complications requiring minimal intervention will also be registered.

Rationale

Percutaneous endoscopic gastrostomy (PEG) is a widespread solution for long term, enteral feeding in paediatric patients who have an eating problem. Most have a history of failed nasogastric tube due to displacement, risk of aspiration and discomfort. Cerebral palsy and other chronic neurological disorders represent the biggest patient group receiving PEG. Other disorders include cystic fibrosis, oesophageal atresia, heart failure, renal failure and malignancy i.e. neuroblastoma and acute lymphoid leukaemia.

The placement of a PEG feeding tube is an invasive procedure, which in most cases are done with the Pull-method as described by Gauderer in 1980. In patients with congenital malformations in the oesophagus and ventricle the Pull-method is contraindicated and the gastrostomy has to be placed by laparotomy. Related to all variations of the procedure is a risk for complications. Complications range from minor, needing little or no intervention, to major, life threatening situations.

By identifying risk factors for specific complications, future PEG-treatment in paediatric patients can be made safer and more personalized.

Description of the cohort

All paediatric (under 16 years) patients, who in the period from 2000 to 2012 were treated with PEG at Odense University Hospital (OUH), Denmark.

Data and biological material

Data will be collected from the patients' available medical history. Information about age, weight, sex, risk factors, indications, interventions and complications will be collected. 

Collaborating researchers and departments

Department of Surgery, Odense University Hospital

• Medical student Erik Sören Halvard Hansen
• Head of Section and Surgical Consultant Lars Rasmussen
• Professor, Surgical Consultant and Head of Research Niels Qvist
• Staff Specialist Mark Bremholm Ellebæk