Percutaneous endoscopic gastrostomy: complications and suggestions to avoid them

Schurink, Carolina A. M.; Tuynman, H. A. R. E.; Scholten, Pieter; Arjaans, W.; Klinkenberg‐Knol, Elly C.; Meuwissen, S. G. M.; Kuipers, Ernst J.

doi:10.1097/00042737-200107000-00010

Cited by 79 publications

(53 citation statements)

References 16 publications

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“…An improvement in quality of life, but not survival, was also reported in PEG-fed patients with head and neck cancer [10]. However, in other types of high-risk cancer or when the prognosis is grave, mortality is too high for PEG to be of any benefit [11]. Taylor et al [3] fed 68 patients with cancer via PEG.…”

Section: Indicationsmentioning

confidence: 99%

Indications for Percutaneous Endoscopic Gastrostomy Insertion: Ethical Aspects

Niv

Abuksis²

2002

Dig Dis

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Percutaneous endoscopic gastrostomy (PEG) is a popular technique for long-term enteral nutrition. However it is not beneficial in all cases, and may even prolong the process of dying. The present article discusses the main indications for PEG insertion, and the ethical considerations involved. Three main questions need to be answered: (1) for what purposes should PEG be used; (2) for what type of patients, and (3) when should PEG be inserted in the natural history of the patient’s illness? PEG is used in patients unable to maintain sufficient oral intake. It has been found to improve quality of life and/or to increase survival in patients with head and neck cancer, acute stroke, neurogenic and muscle dystrophy syndrome, growth failure (children) and gastric decompression. It led to no improvement in nutritional or functional status in patients with cachexia, anorexia, aspiration (and aspiration pneumonia), and cancer with a short life expectancy. Several court decisions have stipulated that PEG need be offered in patients in a persistent vegetative state or patients with senile dementia who have lost the ability for self-determination. Since the 30-day mortality after PEG insertion is very high for patients hospitalized in a general medical center, a ‘cooling off’ period of 30–60 days should be scheduled from the time of the PEG request to actual insertion.

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Section: Indicationsmentioning

confidence: 99%

Indications for Percutaneous Endoscopic Gastrostomy Insertion: Ethical Aspects

Niv

Abuksis²

2002

Dig Dis

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“…Although that 8,9) . In case with rare but life -threatening PEG -related complications such as bleeding or perforation, we occasionally have to change the scopes which enable us to use various devices during PEG placement if we use transnasal EGD.…”

Section: Discussionmentioning

confidence: 98%

Prospective Randomized Comparative Study of Hemodynamic Changes Between Ultrathin Transnasal and Conventional Transoral Esophagogastroduodenoscopy in Percutaneous Endoscopic Gastrostomy Placement With Modified Introducer Method Under Sedation

Suzuki

Hikichi

Satō

et al. 2011

FJMS

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: AIM : Percutaneous Endoscopic Gastrostomy (PEG) placement is a useful but invasive method. Recently, the hemodynamic change of ultrathin transnasal esophagogastroduodenoscopy (transnasal EGD) was reported as less than that of conventional transoral EGD (transoral EGD). This study compared hemodynamic changes between transnasal EGD and transoral EGD in the setting of PEG placement using a modified Introducer method under sedation. METHODS : All 25 patients who were performed PEG in our hospital during the period December 2007 to February 2009 were enrolled in this study. We assigned them randomly to one of two groups, Group A for transoral EGD and Group B transnasal EGD. For both groups, the modified Introducer method was used. Vital signs (systolic blood pressure ; SBP, heart rate ; HR and rate pressure product ; RPP) were monitored before and after scope insertion. RESULTS : We assigned 13 patients to Group A and 12 patients to Group B. The mean age was 69.4 years old in Group A and 69.8 in Group B. After scope insertion, mean changes of vital signs in Group A and B were, respectively, 17.8 mmHg and 17.3 mmHg in SBP, 12.1 bpm and 5.08 bpm in HR, and 25.9 and 17.5 in RPP. CONCLUSION : No significant differences of hemodynamic changes were seen between transnasal EGD and transoral EGD for the PEG placement with modified Introducer method under sedation. Results show that both methods are tolerable and feasible for PEG placement.

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“…'nın (20) 254 olguluk serilerinde % 13 olguda PEG tüpünün çevresinde lokal enfeksiyon, % 8 olguda perforasyon, peritonit gibi majör komplikasyonlar gözlemlenmiştir. Çalışmamızda 3 olgumuzda yara yerinde lokal infeksiyon görülmüş, intravenöz antibiyoterapi ile gerilemiştir.…”

Section: Discussionunclassified

Percutaneous endoscopic gastrostomy in intensive care unit

Gürsoy¹,

Uğur²,

Çivi³

2015

MedJ

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GİRİŞEnteral nütrisyon (EN); yoğun bakım hastalarında gastrointestinal sistemin normal florasının ve yapı-sal bütünlüğünün korunması, translokasyon riskinin azaltılması, bağırsağın immun ve endokrin fonksiyonlarının devamlılığının sağlanması ve ciddi hastalıkların neden olduğu katabolik süreci sınırlamada kritik rol oynamaktadır (1) . Yoğun bakım hastalarında enteral nütrisyonu sağlamada ilk tercih edilen yol oral

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Percutaneous endoscopic gastrostomy: complications and suggestions to avoid them

Cited by 79 publications

References 16 publications

Indications for Percutaneous Endoscopic Gastrostomy Insertion: Ethical Aspects

Indications for Percutaneous Endoscopic Gastrostomy Insertion: Ethical Aspects

Prospective Randomized Comparative Study of Hemodynamic Changes Between Ultrathin Transnasal and Conventional Transoral Esophagogastroduodenoscopy in Percutaneous Endoscopic Gastrostomy Placement With Modified Introducer Method Under Sedation

Percutaneous endoscopic gastrostomy in intensive care unit

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