Safety of the One Step Percutaneous Endoscopic Gastrostomy (Push-PEG) Button in Pediatric Patients.

OBJECTIVES: Percutaneous Endoscopic Gastrostomy (PEG) - Systems are essential tools for enteral feeding in a broad variety of pediatric patients. The One Step ("Push-PEG") technique allows the direct introduction of a PEG-Button. The aim of the study was to investigate the safety and parental view of the Push-PEG technique.

METHODS: We conducted a single-center retrospective data and questionnaire (SDC, https://links.lww.com/MPG/D296 ) based study including all pediatric patients receiving a PEG via push or pull technique between 2015 until end of 2020 and compared these two groups. The primary outcome was the detection of minor and major complications. Secondary outcomes were growth, thriving and parental contentment using a likert-scaled questionnaire .

RESULTS: 83 patients were included in the analysis. There were no significant differences in the basic data regarding age, weight or diagnosis category. Overall complication rate was 34,9%. The Push-PEG group showed a lower rate of complications (32,7% vs 38,7%) and a lower rate of major complications (4.1% vs 8,8%), although the difference is not significant. 34 families completed the questionnaire (SDC, https://links.lww.com/MPG/D296 ) (response rate 40%). There were no significant differences between the two groups regarding answers of the likert-scaled questions.

CONCLUSION: Push-PEG placement seems to be as safe as placement via traditional pull technique, even in small infants more than 2.8 months and 4 kg. As Push-PEG placement requires less follow-up interventions it may show significant advantages and could be the method of first choice in many cases.