Percutaneous endoscopic gastrostomy in long-term coma patients at different phases: a report from neurosurgical department

Abstract

Objective To evaluate percutaneous endoscopic gastrostomy （PEC） in long-term coma patients at different phases who received trans-nasal feeding in Department of Neurosurgery. Methods A total of 51 patients who received trans-nasal feeding because of long-term coma were randomly divided into 2 groups to undergo PEG at 25-39 days after coma （n =24） or at 40-60 days （n = 27） , respectively. The rates of upper gastrointestinal bleeding, average episodes of bleeding, average hemostatic time, the rates of aspiration and aspiration pneumonia were compared between the 2 groups. Results The rates of upper gastrointestinal bleeding, aspiration and aspiration pneumonia in post-PEG patients were significantly lower than those in pre-PEG patients （P 〈 0.05）. Before the procedure of PEG, the rates of upper gastrointestinal hemorrhage,average episodes of bleeding, rates of aspiration and aspiration pneumonia in 25-39-day group were significantly lower than those in 40-60-day group （P 〈 0.05）. There was no significant difference between 2 groups, in regarding of either hemostatic time, or rates of upper gastrointestinal bleeding, aspiration and aspiration pneumonia after PEG （P 〉 0. 05）. Conclusion PEG may decrease the rates of upper gastrointestinal bleeding, aspiration and aspiration pneumonia in neurosurgical patients receiving trans-nasal feeding because of long-term coma. PEG is preferably performed on 25-39 days of onset to 40-60 days. If there is no contraindication, 25-39 days after coma is likely to be the optimal time for PEG. Key words: Time factors ; Endoscopes ; Intubation, nasogastric ; Coma