Naše zkušenosti s perkutánní endoskopickou gastrostomií u dětí

Our Experience with Percutaneous Endoscopic Gastrostomy in Children

The authors describe their experience with percutaneous gastrostomy (PEG) in children. In 1992 - 1998 PEGand/or a so-called gastrostomic „button“ was introduced to 12 children age 0.6 - 15.5 years and the period ofinsertion was 2 months - 4.08 years, mean 1.43 years. In 10 children the indication for the procedure were impaireddeglutition associated with cerebral palsy, foetal alcoholic syndrome, Smith-Lemli-Opitz syndrome, viral encep-halitis, posthypoxic encephalopathy and in two instances the necessity of nutritional support of children with cysticfibrosis. The introduction of PEG was complicated 5 times by vomiting, twice by granulations in the wound andonce by a yeast infection and in one instance after discontinued nutrition obliteration of the gastrostomic canal didnot occur. Antireflux plastic operations were performed in one child before introduction of gastrostomy and onceafter introduction of PEG after vomiting. Into the tube preparations for enteral nutrition were introduced as wellas a mixed diet. In subjective evaluations of the method by parents or staff in 90% satisfaction was expressed. Onemother of a child with CF was not satisfied with treatment. The problem is absence of a system ensuring at anorganizational level domicilary care.

Key words:
percutaneous endoscopic gastrostomy in children, impaired deglutition, cystic fibrosis