PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: RESULTS OF 50 CASES

Authors : Rasim GENÇOSMANOĞLU, Orhan ŞAD, Erol AVŞAR, Hülya Över HAMZAOĞLU, Osman ÖZDOĞAN, Cem KALAYCI, Nurdan TÖZÜN

Pages : 212-218

View : 19 | Download : 10

Publication Date : 2016-12-03

Article Type : Research Paper

Abstract :Objective: To present the results of percutaneous endoscopic gastrostomy insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(96%);. Of the 50 cases 26 insert ignore into journalissuearticles values(52%); were men and 24 insert ignore into journalissuearticles values(48%); women with the median age of 63 years insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(2 infections, 2 Parkinson’s disease, 1 Alzheimer’s disease);, head injury in 3, iatrogenic in 1 insert ignore into journalissuearticles values(esophago- cutaneous fistula);, and hypoxic encephalopathy in 1. The durability of the tube was a median of 217.5 days insert ignore into journalissuearticles values(range 9 to 1669 days);. In 9 patients the tube was removed with a median of 158.5 days insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(range 35 to 1252 days);. Of these patients, 2 needed replacement tube insertion twice and 3 three times. Two insert ignore into journalissuearticles values(4%); cases had minor complications insert ignore into journalissuearticles values(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% insert ignore into journalissuearticles values(4/50);, and overall mortality of 32% insert ignore into journalissuearticles values(16/50);. The mortality rate was 63.6% insert ignore into journalissuearticles values(7/11); for patients who had brain tumor and 23% insert ignore into journalissuearticles values(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.
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