Gastropexy device impaction in children with push percutaneous endoscopic gastrostomy

One-step button percutaneous endoscopic gastrostomy (B-PEG) is a method for gastrostomy placement. Few studies have described complications associated with T-fasteners. This study aimed to assess the incidence and risk factors of post-gastrostomy T-bar retention. Children who underwent one-step button percutaneous endoscopic gastrostomy (B-PEG) placement in our tertiary center between 2009 and 2020 were included in this retrospective study. Patient characteristics, comorbidities, complications, and potential risk factors were analyzed. All post-procedure radiological examinations, T-bar numbers, and durations post-procedure were collected. T-bar retention was considered at least one T-bar after 6 weeks post-B-PEG. A total of 679 children (337 boys; median age at B-PEG, 1.7 years) were included. Among 483 patients with radiological examinations analyzed, 361 (74.7%) had at least one T-bar impaction at the first radiological examination (median time after B-PEG, 0.55 years). Younger age at B-PEG was a risk factor for T-bar impaction (odds ratio [OR]: 2.82, 95% confidence interval [CI]: [1.71-4.66], P < .0001). Nearly 75% of children presented T-bar impaction. These data indicate that to avoid gastropexy complications, discussion of early removal of T-fasteners post-B-PEG is warranted.