{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T13:06:56Z","timestamp":1759496816493,"version":"3.40.5"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003The T-fasteners gastrostomy (T-PEG) has become increasingly popular over recent years as an alternative to the \u201cpull-technique\u201d gastrostomy (P-PEG). This study aimed to compare P-PEG and T-PEG complications.<\/jats:p><jats:p>\n          Materials and Methods\u2003A retrospective observational study of pediatric patients who underwent percutaneous endoscopic gastrostomy (PEG) placement. P-PEG was performed using the standard Ponsky technique and was replaced after 6 months by a balloon gastrostomy under sedation. T-PEG was performed using three percutaneous T-fasteners (that allow a primary insertion of a balloon gastrostomy). The balloon was replaced by a new one after 6 months without sedation. Complications were recorded.<\/jats:p><jats:p>\n          Results\u2003In total, 146 patients underwent PEG placement, 70 P-PEG and 76 T-PEG. The mean follow-up was 3.9 years (standard deviation\u2009=\u20099.6). Age, weight, and associated comorbidities were comparable (p\u2009&gt;\u20090.05). The overall complications were 17 (24.2%) in the P-PEG group and 16 (21.0%) in the T-PEG group (p\u2009&gt;\u20090.05). P-PEG was associated with more sedation for button replacement (97 vs. 2.6% [p\u2009&lt;\u20090.05]). P-PEG was associated with more early tube dislodgement during the first replacement (7.2 vs. 1.4% [p\u2009=\u20090.092]). Two of the five dislodged gastrostomies in the P-PEG group underwent laparotomy due to peritonitis, whereas the only dislodged gastrostomy in the T-PEG group was solved endoscopically. Altogether, P-PEG was associated with more complications that required urgent endoscopy, laparotomy, or laparoscopy (18.6 vs. 6.6% [p\u2009&lt;\u20090.05]).<\/jats:p><jats:p>\n          Conclusions\u2003P-PEG was associated with more sedation, complications during first button replacement, and complications requiring urgent endoscopy, laparotomy, or laparoscopy compared with T-PEG.<\/jats:p>","DOI":"10.1055\/a-2340-9475","type":"journal-article","created":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T23:04:12Z","timestamp":1717801452000},"page":"201-207","source":"Crossref","is-referenced-by-count":2,"title":["Percutaneous Endoscopic Gastrostomy with T-Fasteners versus \u201cPull Technique\u201d: Analysis of Complications"],"prefix":"10.1055","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6952-0587","authenticated-orcid":false,"given":"Alejandra","family":"Castrillo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Urology, Vall d'Hebron University Hospital, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Garc\u00eda-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Urology, Vall d'Hebron University Hospital, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"La\u00edn","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Urology, Vall d'Hebron University Hospital, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Gin\u00e9","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Urology, Vall d'Hebron University Hospital, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"D\u00edaz-Herv\u00e1s","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Urology, Vall d'Hebron University Hospital, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Urology, Vall d'Hebron University Hospital, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,6,25]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s12519-018-0206-y","article-title":"Complications in children with percutaneous endoscopic gastrostomy (PEG) placement","volume":"15","author":"B Balogh","year":"2019","journal-title":"World J Pediatr"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1016\/j.jpeds.2015.03.008","article-title":"Safety of the one-step percutaneous endoscopic gastrostomy button in children","volume":"166","author":"A Jacob","year":"2015","journal-title":"J 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after implementation of a detailed treatment protocol for percutaneous endoscopic gastrostomy with T-fastener fixation in pediatric patients: a prospective study","volume":"57","author":"M O Dahlseng","year":"2022","journal-title":"J Pediatr Surg"},{"issue":"09","key":"ref10","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1016\/j.jpedsurg.2004.05.018","article-title":"Gastrostomy revision: incidence and indications","volume":"39","author":"S J Conlon","year":"2004","journal-title":"J Pediatr Surg"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/SLA.0b013e3181b13ca2","article-title":"The Clavien-Dindo classification of surgical complications: five-year experience","volume":"250","author":"P A Clavien","year":"2009","journal-title":"Ann Surg"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"618","DOI":"10.3748\/wjg.v22.i2.618","article-title":"Buried bumper syndrome: a complication of percutaneous endoscopic gastrostomy","volume":"22","author":"J Cyrany","year":"2016","journal-title":"World J Gastroenterol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.12968\/bjcn.2018.23.Sup7.S28","article-title":"Buried bumper syndrome: do we have enough evidence?","volume":"23","author":"J Bennell","year":"2018","journal-title":"Br J Community Nurs"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.2214\/AJR.17.19411","article-title":"Removal of T-fasteners immediately after percutaneous gastrostomy tube placement: experience in 488 patients","volume":"211","author":"M L Sanogo","year":"2018","journal-title":"AJR Am J Roentgenol"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1089\/lap.2006.16.643","article-title":"U-stitch laparoscopic gastrostomy technique has a low rate of complications and allows primary button placement: experience with 461 pediatric procedures","volume":"16","author":"C J Aprahamian","year":"2006","journal-title":"J Laparoendosc Adv Surg Tech A"}],"container-title":["European Journal of Pediatric 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