‘Cut and push’ as an alternative to endoscopic retrieval of PEG type gastrostomy tubes
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Read the article on link.springer.com ↗Article · Jan 2023 · 1 min read
In brief
In brief
This retrospective study of 27 pediatric cases demonstrates that the 'Cut and Push' method for PEG tube removal is a safe, minimally invasive alternative to endoscopic removal under general anesthesia. With no complications observed and significantly shorter wait times (14 days vs 6 months), this technique offers reduced resource burden while avoiding anesthesia risks in children.
Written by the GCMD Library team from the article.
Abstract
Purpose
Percutaneous Endoscopically placed Gastrostomy (PEG) tubes are frequently used in children. The traditional endoscopic method to remove/change the PEG device requires general anaesthesia in children. A minimally invasive alternative is the ‘Cut and Push’ method (C&P): avoiding the risks/wait times of general anaesthesia and reducing resource burden. Data regarding the safety/effectiveness of C&P in children are lacking with concerns raised about the possibility of gastrointestinal obstruction.
Methods
We retrospectively reviewed all cases of PEG removal / change to button in children (< 18 years) between December 2020 and January 2022. Cases were identified from a prospectively maintained database and all cases of C&P included. Parents/carers were asked if the child had suffered any complications following C&P and if flange was visualised in stools.
Results
During the time period, 27 PEGs were either removed or changed to button via C&P. The average waiting time for C&P was 14.29 days, significantly shorter than the minimum 6-month waiting time for elective endoscopy. Our evaluation revealed no complications of C&P at median 70 days (range 25–301). In three cases the flange was visualised in the stool, at 2 days, 3 days and 5 weeks following C&P respectively.
Discussion
These data support the available literature suggesting C&P is an effective means to facilitate minimally invasive and prompt PEG removal/change to button in children. We recommend minimum weight and age parameters for this procedure and further evaluation of the safety and resource implications of this technique.