Risk Factors and Complications Following Percutaneous Endoscopic Gastrostomy: A Case Series of 1041 Patients

Richter-Schrag, Hans Juergen; Richter, Sabine; Ruthmann, O.; Olschewski, Manfred; Hopt, Ulrich T.; Fischer, Andreas

doi:10.1155/2011/609601

Cited by 88 publications

(71 citation statements)

References 26 publications

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“…In the present study, no antibiotic prophylaxis was used, and the rate of peristomal infections observed in the present study was 2.3 %, lower than the rates (5-36 %) reported in earlier literature [19][20][21]. Risk factors include cancer, cirrhosis, radiation exposure, diabetes, the size of the tube, and experience [17][18][19][20][21][22].…”

Section: Discussioncontrasting

confidence: 64%

“…Out of five patients in the present study, the diagnosis was confirmed by endoscopy in two and Although reported complications associated with bleeding are frequent, the rate of such complications was relatively low in the present study. While the ESPEN guidelines recommend maintaining an INR of below 1.5 in order to reduce bleeding complications [7], in a study of 1041 patients, Richter-Schrag et al reported that the use of anticoagulants and increased INR values do not increase the rate of bleeding complications [22]. In the present study, the patients were provided with continuous anticoagulant treatment prior to the procedure but kept their INR level below 2.5.…”

Section: Discussionmentioning

confidence: 85%

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Percutaneous Endoscopic Gastrostomy: Technical Problems, Complications, and Management

et al. 2015

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Percutaneous endoscopic gastrostomy (PEG) is an important technique for the provision of nutrition. The present study presents data from our analysis of the PEG procedure. Patients administered with PEG at the endoscopy unit of the 19 Mayıs University General Surgery Department between 2007 and 2013 were analyzed retrospectively, and technical problems, indications, and complications related to the PEG procedure in 221 patients were evaluated. Of the patients, 60 % were male and the median age was 61 years (18-92 years). The most frequent indication was admittance to the intensive care unit, accounting for 46 % of the total, followed by neurological disease, with 41 %. The success rate of the procedure was 98 %, and the overall rate of complications was 22 %. No mortalities were reported as resulting from the procedure. The most common complication was the development of granulomas around the tube (8 %). PEG is a safe method of longterm feeding but is associated with a high rate of morbidity that can be treated easily using conservative treatment methods.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 85%

Percutaneous Endoscopic Gastrostomy: Technical Problems, Complications, and Management

et al. 2015

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“…The most common complication of PEG placement is peristomal wound infection, which occurs in approximately 11% within 1 week of placement. One recent study found the rate of peristomal wound infection to be significantly increased amongst patients with malignancy, cirrhosis, and radiation exposure [28]. One limitation of this study was that the provision of periprocedure prophylactic IV antibiotics was not universal, which is the current recommendation in North America.…”

Section: Introductionmentioning

confidence: 89%

“…Problem: high complication rate and 30-day mortality rate; solution -careful patient selection and use of a multidisciplinary enteral access service Even through society guidelines recommend against PEG placement in patients with an expected survival of less than 30 days, the short-term mortality following PEG placement remains relatively high, with a 30-day mortality rate of 5.8-6.5%, 60-day mortality rate of 10-18%, and 1-year mortality rate of 32-41% [28][29][30]. In a retrospective review of over 1000 patients undergoing PEG, predictors of 30-day mortality included: age over 56 years [odds ratio (OR) 1.04, 95% confidence interval (CI) 1.00-1.07], and diabetes mellitus (OR 4.45, 95% CI 1.33-13.01).…”

Section: Introductionmentioning

confidence: 99%

Endoscopic solutions to challenging enteral feeding problems

Paski¹,

Dominitz²

2012

Current Opinion in Gastroenterology

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“…Minör komplikasyonlar olarak kabul edilen bu grup içinde en sık görülenler yara yeri enfeksiyonu ve katater kenarından sızdır-madır. Bizim çalışmamızda enfeksiyon en sık görülen komplikasyondur ve bazı durumlarda kateterin çekilmesini gerektirebilir [21]. Çalışmamızda 8(%8,2) hastada lokal yara yeri enfeksiyonu ve 2(%2,1) hastamızda tüp kenarından sızdırma olmuş ve basit antibiyotik tedavisi ile kontrol altına alınarak tüpün çekil- mesini gerektirecek bir durum izlenmemiştir.…”

Section: Gereç Ve Yöntemunclassified

Effect of Body Mass Index on Processing Time and Morbidity in Elderly Percutaneous Endoscopic Gastrostomy Patient

2016

Ann Clin Anal Med

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ÖzetAmaç: Oral yoldan beslenemeyen ancak gastrointestinal sistem fonksiyonları normal olan yaşlı hastalarda perkütan endoskopik gastrostomi (PEG) işle-minin güvenilirliğini değerlendirmek, hastaların vücut kitle indeksi (VKİ) ile iş-lem süresi ve komplikasyon oranları arasındaki ilişkiyi belirlemektir. Gereç ve Yöntem: 2011 Şubat ve 2014 Aralık ayları arasında çekme yöntemi ile yü-zeyel anestezi altında PEG yerleştirilen, 65 yaşın üstündeki 97 hastanın klinik verileri ve komplikasyon oranları retrospektif olarak incelendi. Tüm hastalar yaş, cins, PEG endikasyonları, komplikasyonlar, işlem süreleri, antibiyotik profilaksi uygulanması, vücut kitle indeksi (VKİ) ve takip süreleri açısından değerlendirildi. Bulgular: Çalışmamızda 51'i (%52,6) kadın, 46'sı(%47,4) erkek toplam 97 hasta mevcuttu. Yaş ortalaması 72 ± 4 idi. PEG endikasyonu olarak 41(%42) olguda serebrovasküler hastalıklar, 19(%19,5) olguda obstrük-siyon yapan malign hastalıklar, 16(%16,5) olguda demans ve 21(%22) olguda diğer hastalıklar saptandı. Vücut kitle indeksi ortalama 25±3(17-32)kg/m² olarak hesaplandı. Ortalama işlem süresi 8,6±1,6 dakika idi. VKİ 25'in üzerin-de olanlarda işlem sürelerinde istatistiksel anlamlı artış saptandı (p<0,05). Toplam 10(%10,2) hastada minör komplikasyon saptandı. 8(%8) olguda antibiyotik tedavisi gerektirecek yara çevresi enfeksiyonu, 2(%2) olguda kateter kenarından hafif sızdırma görüldü. VKİ 25'in üstünde olanlarda komplikasyon oranının istatistiksel anlamlı yüksek olduğu saptandı (p<0,05). Hastaların takip süresi 224(68-660) gün olup işleme ait mortalite saptanmamıştır. Tartışma: PEG, çeşitli nedenlerle oral yoldan beslenemeyen olgularda uzun süre-li ve en uygun beslenme desteği sağlayan güvenli bir yöntemdir. VKİ yüksek hastalarda, işlem sırasında komplikasyon riski açısından daha özenli uygulama gerekebilmektedir. Anahtar KelimelerGastrostomi; Enteral Beslenme; Endoskopi; Vücut Kitle İndeksi; Geriatrik Abstract Aim: We aimed to assess the reliability of percutaneous endoscopic gastrostomy (PEG) applications and to investigate the relationship between body mass index and duration of the procedure and complication rates of geriatric patients. Material and Method: Between 2011 February and 2014 December, we retrospectively analyzed the clinical data and complication rates of 97 geriatric patients to whom PEG was applied by the pull method under superficial anesthesia. All patients were evaluated in terms of age, sex, PEG indications, and complications, time of procedure, body mass index (BMI), antibiotic prophylaxis and follow up period. Results: 51(53%) of our patients were female and 46(47%) were male with a mean age of 72 ± 4. Cerebrovasculer disease was seen in 41(42%) cases, malign disease which cause an obstruction in 19(19,5%) cases, dementia in 16(16,5%) cases and other disease in 21(22%) cases as etiologic causes. The BMI of the patients were 25±3(17-32)kg/m². The mean time of duration of the procedure was 8,6±1,6 minute. It was found statistically significance between BMI (up to 25 kg/m²) and prolonged dur...

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Risk Factors and Complications Following Percutaneous Endoscopic Gastrostomy: A Case Series of 1041 Patients

Abstract: Cancer, cirrhosis and radiation therapy were predictors of infection. Post-PEG bleeding and other complications were rare events. Collectively, the data suggested that patients taking concurrent anticoagulants had no elevated risk of post-PEG bleeding.

Cited by 88 publications

References 26 publications

Percutaneous Endoscopic Gastrostomy: Technical Problems, Complications, and Management

Percutaneous Endoscopic Gastrostomy: Technical Problems, Complications, and Management

Endoscopic solutions to challenging enteral feeding problems

Effect of Body Mass Index on Processing Time and Morbidity in Elderly Percutaneous Endoscopic Gastrostomy Patient

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