Our experience with percutaneous endoscopic gastrostomy and long-term follow-up results

Yıl 2022, Cilt: 4 Sayı: 4, 455 - 458, 22.10.2022

Serdar Durak Sami Fidan Murat Erkut Arif Mansur Coşar

https://doi.org/10.38053/acmj.1179111

Öz

Aim: Percutaneous endoscopic gastrostomy (PEG) is the preferred method for long-term enteral feeding of patients who cannot be fed orally for various reasons and have a functioning gastrointestinal system. In this study, we aimed to present and discuss the demographic characteristics, indications, and early and late complications of patients implanted with the endoscopic PEG in our center.
Material and Method: In this study, we retrospectively evaluated age, gender, chronic diseases, indication for PEG, complications during the procedure, complications arising from PEG during patient follow-up, and survival times of 84 patients who underwent PEG between January 2016 and January 2020 from the electronic medical file system.
Results: Of the 84 patients enrolled in the study, 59.5% (n=50) were male and 40.5% (n=34) were female. The mean age of the patients was 61.35±19.52 years. The endoscopic PEG success rate was 97.6%. Of the requests for PEG, 58.6% (n=50) were for patients in intensive care units. The most common indications for PEG insertion were cerebrovascular accident (CVA), chronic nervous system disease, and hypoxic-ischemic encephalopathy. Complications related to PEG were observed in 11 patients. All complications were mild, and no severe complications were observed. While one of the complications developed in the early period (<30 days), the other complications occurred in the long term (> 30 days). No deaths from causes related to the PEG procedure have been observed.
Conclusion: In patients with inadequate oral intake, PEG is a safe and appropriate option for continuous enteral feeding because of its low complication and mortality rates.

Anahtar Kelimeler

Percutaneous endoscopic gastrostomy, complication, enteral nutrition

Kaynakça

• Alverdy J, Chi HS, Sheldon GF. The effect of parenteral nutrition on gastrointestinal immunity. The importance of enteral stimulation. Ann Surg 1985; 202: 681–4.
• Deitch EA, Ma WJ, Ma L, Berg RD, Specian RD. Protein malnutrition predisposes to inflammatory-induced gut-origin septic states. Ann Surg 1990; 211: 560–7.
• Hossein SM, Leili M, Hossein AM. Acceptability and outcomes of percutaneous endoscopic gastrostomy (PEG) tube placement and patient quality of life. Turk J Gastroenterol 2011; 22: 128–33.
• Gauderer MW, Ponsky JL, Izant RJ. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg 1980; 15: 872–5.
• Conroy T. The Prevention and Management of complications associated with established percutaneous gastrostomy tubes in adults: a systematic review. JBI Database System Rev Implement Rep [Internet] 2009; 7: 1–37.
• Arvanitakis M, Gkolfakis P, Despott EJ, et al. Endoscopic management of enteral tubes in adult patients - Part 1: Definitions and indications. European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2021; 53: 81–92.
• Temiz A, Aslan OB, Albayrak Y, Albayrak F, Kısaoğlu A, Er S. Percutaneous endoscopic gastrostomy: indications and complications. Akademik Gastroenterol Derg 2015; 14: 113–6.
• Kimyagarov S, Turgeman D, Fleissig Y, Klid R, Kopel B, Adunsky A. Percutaneous endoscopic gastrostomy (PEG) tube feeding of nursing home residents is not associated with improved body composition parameters. J Nutr Health Aging 2013; 17: 162–5.
• Hutchinson E, Wilson N. Acute stroke, dysphagia and nutritional support. Br J Community Nurs 2013; S26-9.
• Kartal M, Kalaycı T, Yeni M. Üçüncü basamak bir sağlık merkezinin perkütan endoskopik gastrostomi deneyimi. Cukurova Anestezi ve Cerrahi Bilimler Derg 2021; 5: 54-60
• Sit M, Kahramansoy N, Tekelioglu UY, Ocak T. Our experience in percutaneous endoscopic gastrostomy. J Academic Res Med 2013; 3: 66–8.
• DiSario JA. Endoscopic approaches to enteral nutritional support. Best Pract Res Clin Gastroenterol 2006; 20: 605–30.
• Akay MA, Yayla D, Elemen L, et al. Percutaneous Endoscopic Gastrostomy; Experience of two clinics. Sakarya Med J 2014; 4: 70–43.
• Peksöz R, Borazan S. Türkiyenin doğusunda II. basamak bir devlet hastanesinin perkütan endoskopik gastrostomi deneyimi. Endoskopi Gastrointestinal 2020; 1–4.
• Erdil A, Tüzün A, Saka M, et al. Perkütan endoskopik gastrostomi uygulamalarımız ve sonuçları. Gülhane Tıp Derg 2001; 43: 379–83.
• Coşkun O. Perkütan endoskopik gastrostomi uygulamasındaki sonuçlarımız: 58 olgunun değerlendirilmesi. Endoskopi Gastrointestinal. 2019; 27: 93-6.
• Kahramanoğlu Aksoy E, Sapmaz F, Akpınar M, et al. Long-term Follow-up Results of Patients with Percutaneous Endoscopic Gastrostomy and Factors Affecting Survival. J Ankara University Faculty of Medicine 2019; 72: 179–83.
• Lucendo AJ, Friginal-Ruiz AB. Percutaneous endoscopic gastrostomy: An update on its indications, management, complications, and care. Rev Esp Enferm Dig 2014; 106: 529–39.
• Fagundes RB, Cantarelli JC, Fontana K, Motta GL. Percutaneous Endoscopic Gastrostomy and Peristomal Infection. Surg Laparosc Endosc Percutan Tech 2011; 21: 275–7.