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Paediatric gastrostomy insertion

Christos Tzivinikos 1

Affiliations

1 Al Jalila Children's Specialty Hospital, DUBAI, United Arab Emirates

Summary

AI Generated

This presentation reviews common mistakes to avoid in paediatric gastrostomy insertion, emphasizing proper patient selection, timing, technique, and the importance of multidisciplinary discussion and parental education.

Gastrostomy should be considered if a child requires nasogastric tube feeding for more than eight weeks, particularly in the first months of life, to prevent oral aversion and support growth in conditions such as neurodisability, prematurity, congenital heart disease, and short gut syndrome.
Absolute contraindications include coagulopathy with INR above 1.5 and frank peritonitis; relative contraindications include VP shunt, severe scoliosis, peritoneal dialysis, and gastric varices, all requiring multidisciplinary team discussion.
Routine fundoplication at the time of PEG placement is no longer recommended, though it may be indicated for recurrent aspiration, proven reflux, or progressive neurological disease.
Antibiotic prophylaxis during the procedure is supported by meta-analyses and reduces infection risk; the speaker notes PEG is not a sterile procedure because the tube passes from mouth through the abdominal wound.
The speaker recommends Mickey button changes always be performed endoscopically and teaches parents to rotate the tube daily to prevent buried bumper syndrome; a case of gastrocolic fistula after difficult button change underscores the need for lateral imaging and air contrast when resistance is encountered.
Parents must understand that gastrostomy provides nutritional support but does not treat reflux or the underlying condition, and the speaker recommends waiting six months of non-use before tube removal, particularly in cardiac patients who may decompensate during winter infections.

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Abstract

Event

UEG Week Berlin 2025

Topics

Endoscopy Nurses Small Intestine & Nutrition Oesophagus Surgery

Session

Mistakes in…: Upper GI

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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PATIENT WITH PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: COLLABORATION WITH PRIMARY HEALTH CARE

Mónica Matos

UEG Presentation

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Screening for gastric cancer: Is it viable?

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Screening for gastric cancer: Is it viable?

Mario Dinis-Ribeiro 1

Affiliations

1 IPO Porto, Porto, Portugal

Summary

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Abstract

Event

UEG Week Berlin 2025

Topics

Digestive Oncology Endoscopy Mechanisms & Personalised Medicine Stomach & H. Pylori Surgery

Session

Gastric cancer: MDT approach

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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PATIENT WITH PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: COLLABORATION WITH PRIMARY HEALTH CARE

Mónica Matos

UEG Presentation

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Long-term outcome post-LTx in adults

Patrizia Burra 1

Affiliations

1 University of Padua-Multivisceral Transplant Unit- Gastroenterology, Padova, Italy

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Abstract

Event

UEG Week Berlin 2025

Topics

Hepatobiliary Surgery

Session

New developments in liver transplantation

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Mónica Matos

UEG Presentation

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Early onset life-long impact: Caustic injury/atresia (Complete Session)

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Early onset life-long impact: Caustic injury/atresia (Complete Session)

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Abstract

Event

UEG Week Berlin 2025

Topics

Oesophagus Paediatrics

Session

Early onset life-long impact: Caustic injury/atresia

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Diverticulitis

Johannes Kurt Schultz

BURNOUT SYNDROME ASSESSMENT OF NURSING STAFF IN A DIGESTIVE ENDOSCOPY UNIT AT A TERTIARY REFERRAL HOSPITAL

YAIZA DEL CARMEN TORRES ZAMORA

PATIENT WITH PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: COLLABORATION WITH PRIMARY HEALTH CARE

Mónica Matos

UEG Presentation

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Diverticulitis

Johannes Kurt Schultz 1

Affiliations

1 Univertsity of Oslo, Oslo, Norway

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Abstract

Event

UEG Week Berlin 2025

Topics

Colorectal Hepatobiliary Primary Care

Session

Cross-cutting: Management changes in high prevalence problems

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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YAIZA DEL CARMEN TORRES ZAMORA

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Mónica Matos

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

BURNOUT SYNDROME ASSESSMENT OF NURSING STAFF IN A DIGESTIVE ENDOSCOPY UNIT AT A TERTIARY REFERRAL HOSPITAL

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BURNOUT SYNDROME ASSESSMENT OF NURSING STAFF IN A DIGESTIVE ENDOSCOPY UNIT AT A TERTIARY REFERRAL HOSPITAL

YAIZA DEL CARMEN TORRES ZAMORA 1

Affiliations

1 Complejo Hospitalario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain

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Abstract

Introduction

Burnout Syndrome is a subject that has been studied for several decades. Despite the fact that is a well-known topic and that more and more people are suffering from it, the bibliography shows that there are no great changes in it and as a consequence, there are still great deficiencies in the prevention of this syndrome today.
In 1981, Maslach and Jackson defined Burnout as a syndrome that occurs when there is inadequate coping with chronic stress, i.e., as a consequence of continuous work stress, negative attitudes and feelings appear both in the professional role itself and towards colleagues, and this makes the person suffering from it emotionally exhausted.
Burnout syndrome is now considered a public health problem because of the number and severity of the consequences for the physical and psychological integrity of workers. According to the International Council of Nurses, professionals who suffer higher levels of work and personal stress are 30% more likely to suffer accidents in their workplace. This means that on the one hand the person suffering from work-related stress and/or burnout syndrome has a series of complications of varying degrees of severity and on the other hand the organisation has to bear the costs involved (e.g. sick leave).

Results & Findings

Observational, descriptive and cross-sectional study, carried out in March 2025 on the nursing staff of our Digestive Endoscopy Unit. A survey was distributed with a section for the analysis of socio-demographic data and another presenting the Maslach Burnout Inventory (MBI) questionnaire.
Descriptive statistical analysis was performed using frequency and association tables.
All questionnaires received were analysed and no exclusion criteria were established. Total sample was 30 professionals, 18 nurses (60%) and 12 TCAES (40%).

Interpreting MBI Scores	LOW BURNOUT	MODERATE BURNOUT	HIGH BURNOUT
EMOTIONAL EXHAUSTION	<19	19-26	>27
DEPERSONALIZATION	<5	6-9	>10
PERSONAL ACCOMPLISHMENT	<33	34-39	>40

Burnout Syndrome was evident in 4 professionals (13,3%) and a total of 10 professionals (33,3%) showed a tendency to suffer from it.

Summary & Discussion

Proffesionals with presence and/or tendency to suffer burnout is characterised by being a professional of nursing on a temporary contract, female, aged 31-45 years and who have been working in our Endoscopy Unit from 5 to 10 years.
It is worth emphasising that there is a significant percentage of professionals who suffer from a high level of emotional exhaustion (63,3%)
Excessive workload (73,3%) and high-pressure job (52,6%), as well as poor workplace relationships (73,7%) are the main precursors highlighted by professionals for the appearance of burn out.

Conclusion

These data show that this is a latent problem and it is therefore necessary to take measures, both of an organisational nature and to intervene in the
nursing staff.

References

Maslach C, Schaufeli WB, Leiter M. 2001. Job burnout. Annual Review of Psychology. 52, 397-422.Gordon, S. 2005.
ICN (13 January 2021). Mass Trauma Experienced by the Global Nursing Workforce. [Internet] 2021 [Access 30/03/2025] Available at: https://www.icn.ch/sites/default/files/inline-files/ICN%20COVID19%20update%20report%20FINAL.pdf
Nursing against the odds: How health care cost cutting, media stereotypes, and medical hubris undermine nurses and patient care. Ithaca, NY: ILR Press (Cornell University Press).
Baiget, D, Chapela, R, López-Pérez, A, Milà, A. Síndrome de burnout entre el personal de enfermería del Servicio de Endoscopia Digestiva del HUVH. Enferm Endosc Dig. [Internet] 2016 [Access 30/03/2025];3(2): 30-37. Available at: http://aeeed.com/documentos/publicos/revista/octubre2016/Enferm%20Endosc %20Dig.%202016;3(2)30-37.pdf

Event

UEG Week Berlin 2025

Topics

Nurses

Submission format

Abstract

Session

Abstracts I: Management and education

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Screening for gastric cancer: Is it viable?

Mario Dinis-Ribeiro

Long-term outcome post-LTx in adults

Patrizia Burra

Early onset life-long impact: Caustic injury/atresia (Complete Session)

Diverticulitis

Johannes Kurt Schultz

BURNOUT SYNDROME ASSESSMENT OF NURSING STAFF IN A DIGESTIVE ENDOSCOPY UNIT AT A TERTIARY REFERRAL HOSPITAL

YAIZA DEL CARMEN TORRES ZAMORA

PATIENT WITH PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: COLLABORATION WITH PRIMARY HEALTH CARE

Mónica Matos

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

PATIENT WITH PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: COLLABORATION WITH PRIMARY HEALTH CARE

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PATIENT WITH PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: COLLABORATION WITH PRIMARY HEALTH CARE

Cláudia Alves 1, Mafalda Ribeiro 1, Mónica Matos 1

Affiliations

1 Unidade Local de Saúde de São José, Lisbon, Portugal

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Abstract

Introduction

The Percutaneous Endoscopic Gastrostomy (PEG) tube is used to provide enteral nutrition when oral intake is not adequate.
Regular follow-up of PEG patients is essential to detect complications and clarify doubts. A partnership protocol was developed with ACES Lisboa Central (ACESLC) and Loures/Odivelas (ACESLO) to improve continuity of care.

Results & Findings

We analyzed data from PEG patients followed between 2023 and 2024. Inclusion criteria for referral to ACES included:
• Clinical stabilization;
• Absence of PEG-related complications requiring hospital admission;
• Willingness and ability of the patient/caregiver to participate actively in care.
Monitoring of the protocol was based on quarterly evaluation of five performance indicators:
1st: Percentage of patients referred to ACES, out of the total seen in PEG review consultations;
2nd: Percentage of referred patients who returned to hospital before the expected date due to complications;
3rd: Percentage of cases in which complete referral documentation, as per protocol, was sent to ACES;
4th: Percentage of cases with confirmation that ACES sent back all required clinical data;
5th: Percentage of compliance with scheduled PEG follow-up appointments at ACESLO.

Indicators	2023				2024
Indicators	1st Quarterly	2nd Quarterly	3rd Quarterly	4th Quarterly	1st Quarterly	2nd Quarterly	3rd Quarterly	4th Quarterly
1st	9%	6%	6%	5%	4%	2%	2%	3%
2nd	40%	0%	29%	20%	10%	25%	0%	0%
3rd	100%	100%	100%	100%	100%	100%	0%	100%
4th	33%	75%	67%	33%	100%	100%	0%	100%
5th	100%	100%	0%	100%	100%	0%	0%	100%

Summary & Discussion

The 1st indicator shows low referral rates in both years, mainly due to out-of-area institutionalization, clinical worsening, or death.
The 2nd indicator indicates fewer unplanned hospital readmissions among referred patients; when they occurred, complications were the cause.
Results show fewer complications and emergency visits, reflecting the benefit of close ACES collaboration.
The 3rd indicator reflects 100% compliance in sending referral documentation.
The 4th indicator showed gaps in home visit records in 2023, improved in 2024 through better coordination.
One challenge was the mismatch between designated ACES nurses and those conducting home visits, which required articulation with family health teams (USF).
The 5th indicator confirms overall adherence to scheduled PEG reviews.

Conclusion

The protocol streamlined follow-up for PEG patients.
In 2024, a previous limitation was overcome, allowing referrals of institutionalized patients within the protocol’s coverage.
As a pioneering project, we aim to share these findings to support protocol expansion to other units.

References

Kurion, M., Andrews, R., Tattersall, R., McAlindon, M., Wong, E., Johnston, A., Hoeroldt, B., Dear, K. & Sanders, D. (2017). Gastrostomies preserve but do not increase quality of life for patients and caregivers. Clinical Gastroenterology and Hepatology. 15, 1047-1054.
Lee, C.,Kang, H., Lim, Y., Lee, J., Koh, M., Lee, J., Yang, C. & Kim, J. (2013). Comparison of complications between endoscopic and percutaneous replacement of percutaneous endoscopic gastrostomy tubes. JKoren Medical Sciences. 28, 1781-1787.
Lucendo, A. J. & Friginal-Ruiz, A. B. (2014). Percutaneous endoscopic gastrostomy: An update on its indications, management, complications, and care. Revista Española de Enfermedades Digestivas. 106(8), 529-539.

Event

UEG Week Berlin 2025

Topics

Nurses

Submission format

Abstract

Session

Abstracts I: Management and education

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Screening for gastric cancer: Is it viable?

Mario Dinis-Ribeiro

Long-term outcome post-LTx in adults

Patrizia Burra

Early onset life-long impact: Caustic injury/atresia (Complete Session)

Diverticulitis

Johannes Kurt Schultz

BURNOUT SYNDROME ASSESSMENT OF NURSING STAFF IN A DIGESTIVE ENDOSCOPY UNIT AT A TERTIARY REFERRAL HOSPITAL

YAIZA DEL CARMEN TORRES ZAMORA

PATIENT WITH PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: COLLABORATION WITH PRIMARY HEALTH CARE

Mónica Matos