A safe "cut, tie and thread-pull" method for percutaneous endoscopic gastrostomy tube removal in children with congenital craniofacial anomalies and pharyngeal stenosis

Percutaneous endoscopic gastrostomy (PEG) is a widely used method for tube feeding with enteral nutrition. Both PEG´s insertion and PEG´s removal are usually easy and uncomplicated. The latter can be, however, of substantial difficulty in children with distorted anatomy, such as pharyngeal stenosis or endured craniofacial trauma, when regular endoscopy is contraindicated. The aim of the study was to assess the very simple, but rarely used method for percutaneous removal of the tube by pulling the thread. Four children (4 males, mean age 4.1 year) were analyzed. In all of them the procedure was successful, quick and uncomplicated. To conclude, the thread method should be recommend in case the endoscopic removal is impossible