• Shin Miyata, Fanglong Dong, Olga Lebedevskiy, Hanna Park, and Nam Nguyen.
• Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, United States; Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, United States. Electronic address: drmiyatas@gmail.com.
• J. Pediatr. Surg. 2017 Sep 1; 52 (9): 1416-1420.

PurposeSafety profile of different gastrostomy procedures in small children has not been well studied. This study was conducted to investigate whether complication and mortality rates differ between surgical gastrostomy (G-tube) and percutaneous endoscopic gastrostomy (PEG) in infants and neonates.MethodsIn this retrospective study utilizing the Kids' Inpatient Database, all infants who underwent either G-tube or PEG as a sole procedure were identified. Variables included age, gender, race, presence of neurological impairment, prematurity, complex chronic condition, and severity of illness/risk of mortality subclasses. Postoperative complication, reoperation, and mortality rates were compared between G-tube and PEG. A subgroup of neonates was also analyzed.ResultsA total of 1456 infants were identified (G-tube n=874, PEG n=582). In univariate analysis, the rates of adverse outcomes were not significantly different (G-tube vs PEG complication rate was 7.3% and 6.7%, p=0.65; mortality rate 1.3% and 0.7%, p=0.29, respectively). Adjusted odds ratios (ORs) for complication were 1.07 (G-tube vs PEG, 95% confidence interval [CI] 0.700-1.620) for overall infants and 1.19 (95% CI 0.601-2.350) for the neonatal subgroup. Similarly, adjusted ORs for mortality did not differ significantly both in infants (OR 1.749, 95% CI 0.532-5.755) and in the neonatal subgroup (OR 2.153, 95% CI 0.566-8.165).ConclusionsWhen G-tube and PEG were performed as the only procedure throughout a hospitalization in infants and neonates, the two techniques had comparable risks of postoperative complications and mortalities.Level Of EvidenceRetrospective comparative study, Level III.Copyright © 2017 Elsevier Inc. All rights reserved.

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