The “cut and push” method of removing percutaneous endoscopic gastrostomy tube is not safe in paediatric patients
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In brief
In brief
This study demonstrates that the 'cut and push' method for PEG tube removal carries significant risks in pediatric patients, with 18.5% experiencing retained internal components and 11.1% requiring major surgical intervention. The authors recommend abandoning this technique in children, particularly those with Down syndrome who may face elevated complication rates.
Written by the GCMD Library team from the article.
Abstract
Purpose
A “cut and push” (CP) approach has been described in the literature for removal of percutaneous endoscopic gastrostomy (PEG) tubes. The aim of this study is to investigate the safety profile of this method in children.
Method
Our study included all children who underwent CP procedure for either removal or replacement of Freka PEG tube at our centre between January 2016 and August 2021. Parents contacted to establish if the internal component had been seen in the stools post-procedure. If not seen, a plain film of chest, abdomen and pelvis was arranged followed by computerised tomography (CT) scan. The presence of the internal component as a retained foreign body on imaging was evaluated along with any complication.
Results
Of the 27 patients included, six (22.2%) patients had the internal component seen in the stool. Five (18.5%) patients in total had a retained internal component with three (11.1%) patients had major complications requiring complex surgical interventions, and two (7.4%) patients required endoscopic retrieval.
Conclusion
Our study reports more severe complications that required complex surgical interventions compared to the previous studies. We believe that this method of removal is not safe in children and should be abandoned. Also, patients with Down syndrome might be at higher risk of retention and complications.