Percutaneous endoscopic gastrostomy in small infants unable to swallow safely.

Durakbasa, Cigdem Ulukaya; Sevuk Ozumut, Sibel; Orhon, Zeynep Nur; Oskayli, Meltem Caglar; Aksu, Burhan

BACKGROUND The data about PEG insertions in small infants is limited with inclusion of older children in most studies. We aimed to evaluate the safety of PEG placement in infants weighing ≤5 kg together with their follow-up results. METHODS A retrospective evaluation of the records between January 2005 and December 2019 was done. RESULTS A total of 43 infants were ≤5 kg at the time of PEG insertion. The mean age was 5±3 (19 days-16 months) months and the mean weight was 4.3±0.6 (2.7-5.0) kg. The primary diagnoses were neurological disorders in 25, metabolic disorders in nine, cleft palates in four, muscular disorders in four and a cardiac disorder in one. All procedures were completed successfully. A self-resolving pneumoperitoneum developed in one (2.3%). The tube was extruded in 6 (14%) patients postoperatively which required suture-approximation of the skin and subcuticular tissues. The tube was removed in four (9%) patients with achievement of oral feeds on the long-term. Eighteen (42%) died of primary diseases. Their median tube days was 12.4 (17 days-73 months) months. The median tube days of 20 (46.5%) patients who are currently being followed up is 50.3 (4.7 month-9.8 years) months. CONCLUSIONS PEG placement is safe in small infants with associated morbidities. Complications related to the procedure are within acceptable limits. The accidental extrusion of the tube was a special consideration in this patient group. The overall mortality was high because of underlying primary diseases.