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PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: RESULTS OF 50 CASES

Yıl 2000, Cilt: 13 Sayı: 4, 212 - 218, 03.12.2016

Öz

Objective: To present the results of
percutaneous endoscopic gastrostomy (PEG), which has been an alternative method to conventional surgical gastrostomy for the last 20 years. PEG is one of the gastrostomy methods used for patients unable to take food orally.
Patients and Methods: Between January 1996 and July 2000, 50 consecutive patients in need of enteral feeding for more than four weeks and undergoing PEG with 20 Fr tube by pull technique were retrospectively evaluated in terms of indication, complications, durability of tube, and mortality. The assessment of wound infection was conducted according to the criteria developed by Jain and Shapiro.
Results: A PEG was successfully positioned in 50 of the 52 referred patients (96%). Of the 50 cases 26 (52%) were men and 24 (48%) women with the median age of 63 years (range 2 to 88 years). Indications for PEG placement were cerebrovascular accident in 20, brain tumors in 11, subarachnoidal hemorrhage in 9, several neurologic disorders in 5 (2 infections, 2 Parkinson’s disease, 1 Alzheimer’s disease), head injury in 3, iatrogenic in 1 (esophago- cutaneous fistula), and hypoxic encephalopathy in 1. The durability of the tube was a median of
217.5 days (range 9 to 1669 days). In 9 patients the tube was removed with a median of 158.5 days (range 35 to 427 days) and then oral feeding was started. The tube was changed in 7 patients who had tube dysfunction because of clogging, porosity or fracture with a median interval of 122 days (range 35 to 1252 days). Of these patients, 2 needed replacement tube insertion twice and 3 three times. Two (4%) cases had minor complications (wound infection) during the the first 30 days. During total followup, two wound infections, one buried bumper syndrome, and one aspiration pneumonia developed. The last patient underwent JETPEG which was performed by introducing a 10 Fr jejunal tube through the 20 Fr PEG opening. Total follow-up was 41.8 patient-years with a procedure-related mortality of 0%, 30-day mortality of 8% (4/50), and overall mortality of 32% (16/50). The mortality rate was 63.6% (7/11) for patients who had brain tumor and 23% (9/39) for the rest.
Conclusion: PEG is a minimally invasive gastrostomy method with low morbidity and mortality rates, easy to follow-up, easy to replace when clogged.
Key Words: Percutaneous endoscopic gastrostomy, Enteral feeding.

Kaynakça

  • Gauderer MWL, Ponsky JL, Izant RJ Jr.
  • Gastrostomy without laparotomy: A
  • percutaneous technique. J Pediatr Surg 1980;15:872-875.
  • Vargo JJ, Ponsky JL. Percutaneous endoscopic gastrostomy: Clinical applications. Medscape Gastroenterology 2000:2(4).
  • Mathus-Vliegen LMH, Honing H. Percutaneous endoscopic gastrostomy and gastrojejunostomy: a critical reappraisal of patient selection, tube function and the feasibility of nutritional support during extended follow-up. Gastrointest Endosc 1999:50:746-754.
  • Scheidbach H, Plorbach T, Groitl fl, Hohenberger W. Percutaneous endoscopic gastrostomy / jejunostomy (PEG/PEJ) for decompression in the upper gastrointestinal tract. Initial experience with palliative treatment of gastrointestinal obstruction in terminally ill patients with advanced carcinomas. Surq Endosc 1999:13:1103- 1105.
  • Sheridan R, Schulz J, Ryan C, Ackroyd E, Basha G, Tompkins R. Percutaneous endoscopic gastrostomy in burn patients. Surg Endosc 1999;13:401-402.
  • Gutt Cn, Held S, Paolucci V. et al. Experiences with percutaneous endoscopic gastrostomy. World J Surg 1996;20:1006-1009.
  • Marks JM, Ponsky JL. Access routes for enteral nutrition. Gastroenterologist. 1995:3:130-139.
  • Stellato TA. Expanded applications of percutaneous endoscopic gastrostomy. Gastrointest Clin N Am 1992;2:249-257.
  • Sawyer AM, Ghosh S, Eastwood MA. Satisfactory outcome of percutaneous endoscopic gastrostomy in two patients with cirrhosis and portal hypertension. Am J Gastroenterol 1995;90:826-828.
  • Akkersdijk WL, van Bergeijk JD, van Egmond T, et al. Percutaneous endoscopic gastrostomy (PEG): comparison of push and pull methods and evaluation of antibiotic prophylaxis. Endoscopy 1995;27:313-316.
  • Yamazaki T, Sakai Y, Hatakeyama R, Hoshiyama Y. Colocutaneous fistula after percutaneous endoscopic gastrostomy in a remnant stomach. Surg Endosc 1999; 13:280- 282.
  • Schapiro GD, Edmundowicz SA. Complications of percutaneous endoscopic gastrostomy. Gastrointest Endosc Clin H Am 1996;6:409- 422.
  • Kohli H, Bloch R. Percutaneous endoscopic
  • gastrostomy: a community hospital
  • experience. Am J Surg 1995;61:191-194.
  • Miller RE, Castleman B, Lacqua EJ, et al.
  • Percutaneous endoscopic gastrostomy:
  • results in 316 patients and review of literature. Surg Endosc 1989;3:186-190.
  • Percutaneous endoscopic gastrostomy: Results of 50 cases
  • Leichus L, PateI R, Johlin F. Percutaneous
  • endoscopic gastrostomy/jejunostomy
  • (PEG/PEJ) tube placement: a novel approach. Gastrointest Endosc 1997:45:79-81.
  • Ponsky JL, Gauderer MWL. Percutaneous endoscopic gastrostomy: a non-operative technique for feeding gastrostomy. Gastrointest Endosc 1981; 27:9-11.
  • Jain HR, Larson DE, Schroeder li, et al. Antibiotic prophylaxis for percutaneous endoscopic gastrostomy. Ann Intern Med 1987;107:824-828.
  • Shapiro M, Munoz 7,A, Tager ID, et al. Risk factors for infection at the operative site after abdominal or vaginal hysterectomy. Pi Engl J Med 1982;307:1661-1666.
  • Light VL, Slezak FA, Porter JA, Gerson LW,
  • McCord G. Predictive factors for early mortality after percutaneous endoscopic gastrostomy. Gastrointest Endosc
  • ;42:330-335.
  • McArdle AH, Palmason C, Morency l, Drown RA. A rationale for enteral feeding as the preferable route for hyperalimentation. Surgery 1981;90:616-623.
  • Russel TR, Drotman M, Horns F. Percutaneous gastrostomy. A new simplified and cost- effective technique. Am J Surg 1984; 148:132-137.
  • Gossner L, Keymling J, Hahn EG, Ell C. Antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG): A prospective randomized clinical trial. Endoscopy 1999,31:119-124.
  • Heymsfield SB, Bethel RA, Ansley JD. Enteral hyperalimentation: an alternative to central venous hyperalimentation. Ann Intern Med 1979;90:63-71.
  • Park R11R, Allison MC, Lary J, et al. Randomised comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia. BMJ 1992; 304:1406- 1409.
  • Wicks C, Gimbson A, Vlavianas P, et al. Assessment of the percutaneous endoscopic gastrostomy feeding tube as part of an integrated approach to enteral feeding. Gut 1992;33:613-616.
  • Panas MZ, Reilly H, Moran A, et al. Percutaneous endoscopic gastrostomy in a general hospital: prospective evaluation of indications, outcome, and randomized comparison of the tube designs. Gut 1994;35:1551-1556.
  • Horton B, Homer-Ward M, Donnelly MT, Long RG, Holmes GET. A randomized prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding after acute dysphagic stroke. BMJ 1996;312:13-16.
  • Wolfsen HC, Rozarek RA, Ball TJ. Value of upper endoscopy preceding percutaneous gastrostomy. Am J Gastroenterol 1990;85:249-251.
  • Arsenberg J, Cohen L, Lewis BL. Marked endoscopic gastrostomy tubes permit one- pass Ponsky technique. Gastrointest Endosc 1991;37:552-553.
  • Sartorl S, Trevisani L, Hielsen I. Percutaneous endoscopic gastrostomy placement using the pull-through or push-through techniques: is the second pass of the endoscope necessary? Endoscopy 1996:28:686-688.
  • StrodeI WE, Lemmer J, Eckhauser F. Early experience with endoscopic percutaneous gastrostomy. Arch Surg 1983; 118:449-451.
  • Larson DE, Burton DD, Schroeder RW, et al. Percutaneous endoscopic gastroenterostomy. Indications, success, complications and mortality in 314 consecutive patients. Gastroenterology 1987,-93:48-52.
  • Foutch PG, Talbert GA, Waring JP, et al. Percutaneous endoscopic gastrostomy in patients with prior abdominal surgery: virtues of the safe tract. Am J Gastroenterol 1988; 83:147-150.
  • Stewart JAD, Hagan P. Failure to transilluminate the stomach is not an absolute contraindication to PEG insertion. Endoscopy 1998:30:621 -622.
  • McCarter TL, Condon SC, Aguilar RC, Gibson DJ, Chen YR. Randomized prospective trial of early versus delayed feeding after percutaneous endoscopic gastrostomy placement. Am J Gastroenterol 1998:93:419- 421.
  • Dormann AJ, Wigginghaus B, Risius H. et al. A single dose of ceftriaxone administered 30 minutes before percutaneous endoscopic gastrostomy significantly reduces local and systemic infective complications. Am J Gastroenterol 1999:94:3220-3224.
  • Patel PH, Thomas E. Risk factors for
  • pneumonia after percutaneous endoscopic gastrostomy. J Clin Gastroenterol
  • ,12:389-392.
  • Elperen EH. Pulmonary aspiration in hospitalized adults. Hutr Clin Pract 1997; 12:5-
  • 1 7
  • Rasim Gençosmanoglu, et al
  • DeLegge MH, Patrick P, Gibbs K. Percutaneous endoscopie gastrojejunostomy with a tapered tip unweighted jejunal feeding tube: improved placement success. Am J Gastroenterol 1996:91:1130-1 134.
  • Wolfsen HC, Rozarek RA, Ball TJ, Patterson DJ, Botoman VA. Tube dysfunction following percutaneous gastrostomy and jejunostomy. Gastrointest Endosc 1990:36:261 -263.
  • DiSario JA, Poutch PG, Sanowski RA. Poor results with percutaneous endoscopic jejunostomy. Gastrointest Endosc 1990;36:257-260.
  • Henderson JM, Strodel WE, Gilinsky HH. Limitations of percutaneous endoscopic jejunostomy. JPEH 1993; 1 7:546-550.
Yıl 2000, Cilt: 13 Sayı: 4, 212 - 218, 03.12.2016

Öz

Kaynakça

  • Gauderer MWL, Ponsky JL, Izant RJ Jr.
  • Gastrostomy without laparotomy: A
  • percutaneous technique. J Pediatr Surg 1980;15:872-875.
  • Vargo JJ, Ponsky JL. Percutaneous endoscopic gastrostomy: Clinical applications. Medscape Gastroenterology 2000:2(4).
  • Mathus-Vliegen LMH, Honing H. Percutaneous endoscopic gastrostomy and gastrojejunostomy: a critical reappraisal of patient selection, tube function and the feasibility of nutritional support during extended follow-up. Gastrointest Endosc 1999:50:746-754.
  • Scheidbach H, Plorbach T, Groitl fl, Hohenberger W. Percutaneous endoscopic gastrostomy / jejunostomy (PEG/PEJ) for decompression in the upper gastrointestinal tract. Initial experience with palliative treatment of gastrointestinal obstruction in terminally ill patients with advanced carcinomas. Surq Endosc 1999:13:1103- 1105.
  • Sheridan R, Schulz J, Ryan C, Ackroyd E, Basha G, Tompkins R. Percutaneous endoscopic gastrostomy in burn patients. Surg Endosc 1999;13:401-402.
  • Gutt Cn, Held S, Paolucci V. et al. Experiences with percutaneous endoscopic gastrostomy. World J Surg 1996;20:1006-1009.
  • Marks JM, Ponsky JL. Access routes for enteral nutrition. Gastroenterologist. 1995:3:130-139.
  • Stellato TA. Expanded applications of percutaneous endoscopic gastrostomy. Gastrointest Clin N Am 1992;2:249-257.
  • Sawyer AM, Ghosh S, Eastwood MA. Satisfactory outcome of percutaneous endoscopic gastrostomy in two patients with cirrhosis and portal hypertension. Am J Gastroenterol 1995;90:826-828.
  • Akkersdijk WL, van Bergeijk JD, van Egmond T, et al. Percutaneous endoscopic gastrostomy (PEG): comparison of push and pull methods and evaluation of antibiotic prophylaxis. Endoscopy 1995;27:313-316.
  • Yamazaki T, Sakai Y, Hatakeyama R, Hoshiyama Y. Colocutaneous fistula after percutaneous endoscopic gastrostomy in a remnant stomach. Surg Endosc 1999; 13:280- 282.
  • Schapiro GD, Edmundowicz SA. Complications of percutaneous endoscopic gastrostomy. Gastrointest Endosc Clin H Am 1996;6:409- 422.
  • Kohli H, Bloch R. Percutaneous endoscopic
  • gastrostomy: a community hospital
  • experience. Am J Surg 1995;61:191-194.
  • Miller RE, Castleman B, Lacqua EJ, et al.
  • Percutaneous endoscopic gastrostomy:
  • results in 316 patients and review of literature. Surg Endosc 1989;3:186-190.
  • Percutaneous endoscopic gastrostomy: Results of 50 cases
  • Leichus L, PateI R, Johlin F. Percutaneous
  • endoscopic gastrostomy/jejunostomy
  • (PEG/PEJ) tube placement: a novel approach. Gastrointest Endosc 1997:45:79-81.
  • Ponsky JL, Gauderer MWL. Percutaneous endoscopic gastrostomy: a non-operative technique for feeding gastrostomy. Gastrointest Endosc 1981; 27:9-11.
  • Jain HR, Larson DE, Schroeder li, et al. Antibiotic prophylaxis for percutaneous endoscopic gastrostomy. Ann Intern Med 1987;107:824-828.
  • Shapiro M, Munoz 7,A, Tager ID, et al. Risk factors for infection at the operative site after abdominal or vaginal hysterectomy. Pi Engl J Med 1982;307:1661-1666.
  • Light VL, Slezak FA, Porter JA, Gerson LW,
  • McCord G. Predictive factors for early mortality after percutaneous endoscopic gastrostomy. Gastrointest Endosc
  • ;42:330-335.
  • McArdle AH, Palmason C, Morency l, Drown RA. A rationale for enteral feeding as the preferable route for hyperalimentation. Surgery 1981;90:616-623.
  • Russel TR, Drotman M, Horns F. Percutaneous gastrostomy. A new simplified and cost- effective technique. Am J Surg 1984; 148:132-137.
  • Gossner L, Keymling J, Hahn EG, Ell C. Antibiotic prophylaxis in percutaneous endoscopic gastrostomy (PEG): A prospective randomized clinical trial. Endoscopy 1999,31:119-124.
  • Heymsfield SB, Bethel RA, Ansley JD. Enteral hyperalimentation: an alternative to central venous hyperalimentation. Ann Intern Med 1979;90:63-71.
  • Park R11R, Allison MC, Lary J, et al. Randomised comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia. BMJ 1992; 304:1406- 1409.
  • Wicks C, Gimbson A, Vlavianas P, et al. Assessment of the percutaneous endoscopic gastrostomy feeding tube as part of an integrated approach to enteral feeding. Gut 1992;33:613-616.
  • Panas MZ, Reilly H, Moran A, et al. Percutaneous endoscopic gastrostomy in a general hospital: prospective evaluation of indications, outcome, and randomized comparison of the tube designs. Gut 1994;35:1551-1556.
  • Horton B, Homer-Ward M, Donnelly MT, Long RG, Holmes GET. A randomized prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding after acute dysphagic stroke. BMJ 1996;312:13-16.
  • Wolfsen HC, Rozarek RA, Ball TJ. Value of upper endoscopy preceding percutaneous gastrostomy. Am J Gastroenterol 1990;85:249-251.
  • Arsenberg J, Cohen L, Lewis BL. Marked endoscopic gastrostomy tubes permit one- pass Ponsky technique. Gastrointest Endosc 1991;37:552-553.
  • Sartorl S, Trevisani L, Hielsen I. Percutaneous endoscopic gastrostomy placement using the pull-through or push-through techniques: is the second pass of the endoscope necessary? Endoscopy 1996:28:686-688.
  • StrodeI WE, Lemmer J, Eckhauser F. Early experience with endoscopic percutaneous gastrostomy. Arch Surg 1983; 118:449-451.
  • Larson DE, Burton DD, Schroeder RW, et al. Percutaneous endoscopic gastroenterostomy. Indications, success, complications and mortality in 314 consecutive patients. Gastroenterology 1987,-93:48-52.
  • Foutch PG, Talbert GA, Waring JP, et al. Percutaneous endoscopic gastrostomy in patients with prior abdominal surgery: virtues of the safe tract. Am J Gastroenterol 1988; 83:147-150.
  • Stewart JAD, Hagan P. Failure to transilluminate the stomach is not an absolute contraindication to PEG insertion. Endoscopy 1998:30:621 -622.
  • McCarter TL, Condon SC, Aguilar RC, Gibson DJ, Chen YR. Randomized prospective trial of early versus delayed feeding after percutaneous endoscopic gastrostomy placement. Am J Gastroenterol 1998:93:419- 421.
  • Dormann AJ, Wigginghaus B, Risius H. et al. A single dose of ceftriaxone administered 30 minutes before percutaneous endoscopic gastrostomy significantly reduces local and systemic infective complications. Am J Gastroenterol 1999:94:3220-3224.
  • Patel PH, Thomas E. Risk factors for
  • pneumonia after percutaneous endoscopic gastrostomy. J Clin Gastroenterol
  • ,12:389-392.
  • Elperen EH. Pulmonary aspiration in hospitalized adults. Hutr Clin Pract 1997; 12:5-
  • 1 7
  • Rasim Gençosmanoglu, et al
  • DeLegge MH, Patrick P, Gibbs K. Percutaneous endoscopie gastrojejunostomy with a tapered tip unweighted jejunal feeding tube: improved placement success. Am J Gastroenterol 1996:91:1130-1 134.
  • Wolfsen HC, Rozarek RA, Ball TJ, Patterson DJ, Botoman VA. Tube dysfunction following percutaneous gastrostomy and jejunostomy. Gastrointest Endosc 1990:36:261 -263.
  • DiSario JA, Poutch PG, Sanowski RA. Poor results with percutaneous endoscopic jejunostomy. Gastrointest Endosc 1990;36:257-260.
  • Henderson JM, Strodel WE, Gilinsky HH. Limitations of percutaneous endoscopic jejunostomy. JPEH 1993; 1 7:546-550.
Toplam 57 adet kaynakça vardır.

Ayrıntılar

Bölüm Original Research
Yazarlar

Rasim Gençosmanoğlu Bu kişi benim

Orhan Şad Bu kişi benim

Erol Avşar Bu kişi benim

Hülya Över Hamzaoğlu Bu kişi benim

Osman Özdoğan Bu kişi benim

Cem Kalaycı Bu kişi benim

Nurdan Tözün Bu kişi benim

Yayımlanma Tarihi 3 Aralık 2016
Yayımlandığı Sayı Yıl 2000 Cilt: 13 Sayı: 4

Kaynak Göster

APA Gençosmanoğlu, R., Şad, O., Avşar, E., Hamzaoğlu, H. Ö., vd. (2016). PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: RESULTS OF 50 CASES. Marmara Medical Journal, 13(4), 212-218.
AMA Gençosmanoğlu R, Şad O, Avşar E, Hamzaoğlu HÖ, Özdoğan O, Kalaycı C, Tözün N. PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: RESULTS OF 50 CASES. Marmara Med J. Haziran 2016;13(4):212-218.
Chicago Gençosmanoğlu, Rasim, Orhan Şad, Erol Avşar, Hülya Över Hamzaoğlu, Osman Özdoğan, Cem Kalaycı, ve Nurdan Tözün. “PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: RESULTS OF 50 CASES”. Marmara Medical Journal 13, sy. 4 (Haziran 2016): 212-18.
EndNote Gençosmanoğlu R, Şad O, Avşar E, Hamzaoğlu HÖ, Özdoğan O, Kalaycı C, Tözün N (01 Haziran 2016) PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: RESULTS OF 50 CASES. Marmara Medical Journal 13 4 212–218.
IEEE R. Gençosmanoğlu, “PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: RESULTS OF 50 CASES”, Marmara Med J, c. 13, sy. 4, ss. 212–218, 2016.
ISNAD Gençosmanoğlu, Rasim vd. “PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: RESULTS OF 50 CASES”. Marmara Medical Journal 13/4 (Haziran 2016), 212-218.
JAMA Gençosmanoğlu R, Şad O, Avşar E, Hamzaoğlu HÖ, Özdoğan O, Kalaycı C, Tözün N. PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: RESULTS OF 50 CASES. Marmara Med J. 2016;13:212–218.
MLA Gençosmanoğlu, Rasim vd. “PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: RESULTS OF 50 CASES”. Marmara Medical Journal, c. 13, sy. 4, 2016, ss. 212-8.
Vancouver Gençosmanoğlu R, Şad O, Avşar E, Hamzaoğlu HÖ, Özdoğan O, Kalaycı C, Tözün N. PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: RESULTS OF 50 CASES. Marmara Med J. 2016;13(4):212-8.