Abstract
<h3>Introduction</h3> Endoscopic gastrostomy (PEG) placement in patients with severe respiratory or neuromuscular compromise carries a high risk of mortality through aspiration and radiological placement (RIG) is usually preferred in this setting. We have used ‘push-PEG’ placement in high risk patients guided by nasal endoscopy, unsedated and seated at 30–45° and here we report the outcomes of this technique compared to RIG placement in high risk patients. <h3>Method</h3> Records were analysed retrospectively for all ‘push-PEGs’ placed since 2008 and compared with records of RIG placements since 2010. Indications, completion rates and complications were compared. <h3>Results</h3> 296 push-PEGs have been placed since 2008 (mostly for head and neck malignancy). 242 were placed by standard per-oral endoscopic guidance and 54 using transnasal endoscopy using a Pentax transnasal endoscope. Of the 54, 27 (50%) were NuPEGs and the other 50% received intravenous sedation (SenPEG). 53/54 (98%) were placed successfully and without complication. One sedated patient experienced a respiratory arrest that required emergency intubation and led to the development of the NuPEG technique, since when no complications have been reported. From 2010–2014, 46 RIGs have been placed. Of these, 89% were successful and uncomplicated with one colonic perforation identified. In two patients where RIG failed due to anxiety or inability to lie flat, NuPEG was performed uneventfully. As a result, NuPEG has entirely replaced RIG in our institution where no RIGs have been placed since 2013. <h3>Conclusion</h3> NuPEG is safer and better tolerated than RIG in patients with respiratory or neuromuscular compromise and is the technique of choice in high risk patients requiring gastrostomy placement. <h3>Disclosure of interest</h3> None Declared.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.