Transnasal Feeding Tube or Percutaneous Endoscopic Gastrostomy for Nutrition of Elderly Patients – Indications, Technique, Results Background: Several observational studies of elderly hospitalized patients have identified strong correlations between malnutrition and the risk of subsequent morbid events. Feeding tubes are a common method for long-term enteral feeding for selected patients, and percutaneous endoscopic gastrostomy (PEG) is often considered the method of choice for gastrostomy placement. The purpose of this investigation was to determine success rates, outcome, complication rates, and procedure-related mortality in patients having undergone PEG tube placement. Patients: A retrospective review of the hospital records of 53 patients (35 males and 18 females; aged 10–90 years; median 58 years) undergoing PEG between January 1, 1994, and July 31, 1999 was conducted. 70% of the patients were older than 50 years when PEG was performed. Indications for gastrostomy were cancer of the oropharyngeal, head and neck region in 24 patients (45%), neurological disorders in 15 patients (28%), gastric and esophageal cancer in 2 patients (4%), esophageal perforation in 2 patients (4%), cachexia in 5 patients (9%), prolonged stay at the intensive care unit in 2 patients (4%), and other diseases in 3 patients (6%). Results: Median follow-up was 22.4 months. 16 patients with oropharyngeal cancer (30%) died 45–1,671 days after PEG tube placement (median 161 days). The underlying disease caused death in 5 patients with neurological disorders (9%) 28–491 days (median 101 days), in 1 patient with esophageal cancer (2%) 90 days, and in 1 patient with esophageal perforation (2%) 5 days after the procedure. One death (2%) was procedure-related occurring 8 days after tube placement. We observed a minor complication rate of 26% (14 patients) as well as a major complication rate of 26% (14 patients). Conclusion: PEG offers a safe, less morbid, cost-effective and easy-to-use method of tube placement in the majority of elderly high-risk patients needing long-term enteral feeding. Furthermore, it provides a temporary nutritional bridge for those patients who regain their ability of swallowing and oral feeding. In our series the complication rates coincide with those described by other authors.