The Efficacy and Limitations of Percutaneous Endoscopic Gastrostomy

Abstract

We analyzed 64 percutaneous endoscopic gastrostomy procedures performed by us between 1986 and 1990. Thirty patients had neurologic disease; 16 had head and neck cancers; eight had other malignancies; two had acquired immunodeficiency syndrome; and eight had other problems. Seven patients died within 30 days of complications (n = 4) or the primary illness (n = 3). Mean follow-up was 6 months; an additional patient died of aspiration and eight others died of their underlying illness. There were 19 complications (32%). Four wound complications occurred. Nine patients developed aspiration pneumonia within 3 days of the procedure, four of whom died in the hospital. Of the 24 patients with a history of aspiration, nine experienced aspiration during or after percutaneous endoscopic gastrostomy. Patients with a history of aspiration were more likely to have perioperative aspiration pneumonia, and patients who experienced aspiration were more likely to die.

Outcomes of Surgical, Percutaneous Endoscopic, and Percutaneous Radiologic Gastrostomies

“…9,13 Despite the minor invasiveness of endoscopic place- ment of percutaneous feeding tubes, [14][15][16] major and minor complications remain a topical problem. [17][18][19][20] The purpose of this descriptive and retrospective investigation was to determine success rates, outcome, minor and major complication rates, and procedurerelated mortality in patients having undergone PEG placement, percutaneous radiological gastrostomy (PRG), and SG in a university teaching hospital.…”

“…We observed a rate of minor complications of 43% (6 patients), 33% (8), and 36% (16) and a major complication rate of 14% (2 patients), 17% (4), and 11% (5) in the SG, PEG, and PRG groups, respectively. Tube function rates at 1 year were 67% (9 patients) and 68% (20) in the SG and PEG groups, respectively, and 10% lower (39) in the PRG group, although the difference was not statistically significant.…”

Enteral feeding. Nasogastric, nasojejunal, percutaneous endoscopic gastrostomy, or jejunostomy: its indications and limitations

“…These include wound dehiscence, infection, leakage, aspiration, and bleeding. The morbidity and mortality rate varies from 3% to 61% 40 and up to 37% respectively. 18 The difference probably relates to the condition of the patient in whom the gastrostomy is performed.…”

Practice parameter: The care of the patient with amyotrophic lateral sclerosis (an evidence-based review) [RETIRED]

“…46 The major risk factors for post-PEG pneumonia include a pre-PEG history of aspiration pneumonia, presence of reflux esophagitis during endoscopy, and concurrent infection. 51,[52][53][54][55][56] Although not studied in ALS, a prokinetic agent (such as cisapride) to enhance gastric emptying may reduce the incidence of post-PEG aspiration. 57 There is some evidence that recurrent aspiration pneumonia in aphonic patients with ALS may be treated with conservative laryngectomy or laryngeal diveresion.…”