Efficacy Of Percutaneous Endoscopic Gastrostomy Research Articles

Procedure-Related Complications and Survival after Gastrostomy: Results from a Japanese Cohort

Introduction: In 2010, a large-scale multi-institutional study in Japan showed a good prognosis for percutaneous endoscopic gastrostomy (PEG). However, the function and efficacy of PEG are not fully understood by patients, families, and health-care professionals; thus, the number of PEG treatments in Japan has declined. Therefore, we aimed to investigate the safety of the PEG procedure and subsequent survival after PEG. Methods: In total, 249 PEGs were performed at Juzenkai Hospital from 2005 to 2017. PEG was originally performed using the pull method and then by a modified introducer method from mid-2011. We examined procedure-related complications and survival rates after PEG. Results: Fifty-one (20.5%) procedure-related complications occurred; emergency surgery was required in 4 cases. Infections accounted for 76.5% (39/51) of complications. More infections occurred with the pull method than with the modified introducer method. The 1-year survival rate was 66.8%; the median survival time was 678 days. Nine patients (3.6%) died within 30 days; no deaths were directly related to PEG. Sex, age, and albumin level before surgery significantly influenced the prognosis. Conclusion: Due to changes in the PEG insertion method and other factors, PEG has become a safer treatment method. Additionally, PEG-based nutritional supplementation is associated with adequate survival.

Efficacy of Percutaneous Endoscopic Gastrostomy for Patients With Esophageal Cancer During Preoperative Therapy.

This study aimed to clarify the benefits and disadvantages of percutaneous endoscopic gastrostomy (PEG) for patients with esophageal cancer (EC) during preoperative therapy. We retrospectively reviewed 92 patients who underwent esophagectomy for EC after preoperative therapy. Patients were divided into the PEG group (n=14) and the control group (n=78) and compared regarding patient characteristics, nutritional status, operative variables, and postoperative complications. In the PEG group first nutritional status and tumor stage were significantly worse, but changes of nutritional status from first visit to operation were significantly better. According to the intraoperative thermal imaging, there was no patient with blood flow disturbance in the gastric conduit due to PEG. Short-term surgical outcomes did not significantly differ. PEG has less adverse effects on gastric tube production in esophagectomy and may be considered in highly selective patients during preoperative therapy.

Short- and long-term outcomes from percutaneous endoscopic gastrostomy with jejunal extension.

There is a paucity of data regarding the safety and efficacy of percutaneous endoscopic gastrostomy with jejunal extension (PEG-J). We evaluated adverse events related to PEG-J and determined the clinical impact of PEG-J in those with chronic pancreatitis (CP). This cohort study included all patients who underwent PEG-J placement in a tertiary-care academic medical center between 2010 and 2012. Main outcome measurements were (1) short- and long-term complications related to PEG-J and (2) changes in weight and hospitalizations during the 12-month period before and after PEG-J in the CP subgroup. Of 102 patients undergoing PEG-J placement, the overall technical success rate was 97%. During a median follow-up period of 22months (1-46months, n=90), at least one tube malfunction occurred in 52/90 (58%; 177 episodes) after a median of 53days (3-350days), requiring a median of two tube replacements. Short-term (<30days) tube malfunction occurred in 28/90 (31%) and delayed in 24/90 (27%); these included dislodgement (29%), clogging (26%) and kinking (14%). In the CP subgroup (n=58), mean body weight (kg) (70 vs. 71, p=0.06) and body mass index (kg/m2, 26 vs. 27, p=0.05) increased post-PEG-J. Mean number of hospitalizations (5 vs. 2, p<0.0001) and inpatient days per 12 months (22 vs. 12, p=0.005) decreased. While we observed no major complications related to PEG-J, half of patients had at least one episode of tube malfunction. In the CP subgroup, jejunal feeding via PEG-J significantly reduced the number of hospitalizations and inpatients days, while improving nutritional parameters.

Efficacy of percutaneous endoscopic gastrostomy in pediatric patients

To analyze the efficacy of percutaneous endoscopic gastrostomy (PEG) in pediatric patients. From October 2011 to October 2014, children in the gastrointestinal ward of Guangzhou Women and Children's Medical Center received PEG or jejunal tube PEG(JET-PEG). The success rate, operation time were recorded. The changes of their weight, enteral nutrition calories and the incidence of pneumonia before and after the first 6 months of operation were compared. Follow-up was conducted until October 2014, the recent and long term complications, the length of indwelling time, the replacement or removal of the tube were recorded, the patients swallowing function or the primary disease's outcomes were observed. Of the 13 cases, 10 were male, 3 were female, their average age was 2 years (range 1.8 months-9 years). We performed PEG for 12 of the patients who had congenital craniofacial problems that led to feeding difficulties or recurrent cough and pneumonia (6/12), or neurological disorders (6/12) with inability to swallow, and in one case JET-PEG was performed, this child suffered from chronic intestinal pseudo-obstruction with vomiting and abdominal distension. The gastrostomy was successful in all the patients through one operation, the average operation time of PEG was (25 ± 3) minutes, JET-PEG was 60 minutes. One local skin infection was noted, no long-term complication occurred. In the first 6 months after operation, all the patients gained weight((5.5-30.5) kg postoperation vs. (3.0-30.0) kg preoperation), and 12 cases' enteral nutrition calories increased (from (209-502) to(272-543) kJ/(kg·d)), the incidence of pneumonia decreased in the children who had recurrent pneumonia before the operation (from (0-1.5) to (0-0.16) per month). Until October 2014, their average length of gastric tube indwelling time was 17.8 months (range 4-36 months). In 4 cases PEG tube was removed when they could eat completely independently, the other 9 needed enteral vein nutrition via PEG tube or jejunal tube, in 3 of them balloon type gastric fistula tube was applied. Two of the 13 cases who had cleft palate received stomatological operations when their weight grew to meet the standard. PEG and JET-PEG are safe and effective method for enteric nutrition feeding in pediatrics, the technique causes minimal trauma and has rapid postoperative recovery, few complications, good aesthetic appearances and simple nursing, it can significantly improve their nutritional status and quality of life.

Efficacy of percutaneous endoscopic gastrostomy on unplanned treatment interruption and nutritional status in patients undergoing chemoradiotherapy for advanced head and neck cancer.

Efficacy of percutaneous endoscopic gastrostomy (PEG) on unplanned treatment interruption and nutritional status was examined in patients undergoing chemoradiotherapy (CRT) for advanced head and neck cancer. We retrospectively reviewed hospital charts of 44 patients with advanced head and neck cancer who were treated with CRT. CRT-induced mucositis of grade 3 or worse and inadequate oral intake of less than one third of their usual intake developed in 33 patients who were recommended PEG placement, but not in 11 patients. Thirteen patients accepted PEG placement and then completed CRT (compliant group). However, among 20 patients who refused both PEG and nasogastoric tube (NGT) placements (non-compliant group), 10 required unplanned interruptions of CRT at a radiation dose around 30-40 Gy (UI-CRT group) while 10 others could complete CRT without interruption (C-CRT group) CRT. Total serum protein levels were significantly decreased after CRT in all patients. It is suggested that therapeutic PEG placement is useful for preventing unplanned interruption of CRT in patients with advanced head and neck cancer. After severe mucositis and inadequate oral intake have developed during CRT, PEG placement should be considered before the radiation therapy dose of 30 Gy.

PWE-177 An Audit to Evaluate the Safety and Efficacy of Percutaneous Endoscopic Gastrostomy (PEG) Placement in Patients with Learning Disabilities

IntroductionGuidelines exist to aid clinicians in selecting patients likely to benefit from percutaneous endoscopic gastrostomy (PEG) placement. Patients with learning disabilities (LD) are distinct from those with dementia in whom...

Nasogastric and Percutaneous Endoscopic Gastrostomy Tube Use in Advanced Head and Neck Cancer Patients: A Comparative Study

ABSTRACTTo compare the efficacy of percutaneous endoscopic gastrostomy (PEG) and nasogastric (NGT) tube administration of enteral nutrition in head and neck cancer patients undergoing curative treatment, the authors conducted a prospective study to compare nutritional outcomes, complications, and patient satisfaction. PEG patients sustained significantly less reduction in nutritional parameters, measured at 6 weeks post insertion, as compared with NGT patients. There was also a statistically significant difference between the two groups in patient's quality of life scores and complications. Comparison could not be done at 6 months because all patients were converted to PEG feeding due to the earlier findings. The authors conclude that PEG is more efficacious than NGT as a channel for nutrition in advanced head and neck cancer patients over a short duration.

Enteral tube feeding for amyotrophic lateral sclerosis/motor neuron disease.

Enteral feeding (tube feeding) is offered to many people with amyotrophic lateral sclerosis/motor neuron disease experiencing difficulty swallowing (dysphagia) and maintaining adequate nutritional intake leading to weight loss. To examine the efficacy of percutaneous endoscopic gastrostomy placement or other tube feeding placement on:(1) survival;(2) nutritional status;(3) quality of life;(4) minor and major complications of percutaneous endoscopic gastrostomy. We searched the Cochrane Neuromuscular Disease Group Trials Register (24 November 2009), MEDLINE (from January 1966 to September 2009), and EMBASE (from January 1980 to September 2009) for all papers on enteral tube feeding in amyotrophic lateral sclerosis/motor neuron disease. The results were screened to identify randomised controlled trials and to identify non-randomized studies that might be worthy of review and discussion. We checked references in published articles and enlisted personal communications to identify any additional references. A priori selection criteria included randomised and quasi-randomized controlled trials evaluating the efficacy of percutaneous endoscopic gastrostomy or other feeding tube placement. Since no such trials were discovered, all prospective and retrospective controlled studies were reviewed in the 'Background' or 'Discussion' sections of the review. We independently assessed study design and extracted data. We considered the following outcomes: (1) survival rate in months (of primary interest), (2) nutritional status measured by weight change, change in body mass index, or other quantitative index of nutritional status, (3) self-perceived quality of life and (4) safety of the procedure as indicated by minor and major complications of surgical or radiological guided PEG tube insertion. We found no randomised controlled trials comparing the efficacy of enteral tube feeding with those people who continued to eat orally, without enteral feeding. We summarized the results of retrospective and prospective studies in the 'Discussion' section. There are no randomised controlled trials to indicate whether enteral tube feeding is beneficial compared to continuation of oral feeding for any of the outcome measures. The 'best' evidence to date suggests a survival advantage for some people with amyotrophic lateral sclerosis/motor neuron disease, but these conclusions are tentative. Evidence for improved nutrition is also incomplete but tentatively favorable. Quality of life has been addressed in studies and needs more attention. Based on a number of recent non-randomized studies comparing surgical and radiographic approaches to feeding tube insertion these two procedures for PEG tube insertion appear to be equivalent.

The Standard of Caring: Why Do We Still Use Feeding Tubes in Patients With Advanced Dementia?

A consensus among geriatricians, ethicists, and neurologists supports a palliative approach to the care of individuals with late-stage dementia. But ten years after the publication of the first large study demonstrating the lack of efficacy of percutaneous endoscopic gastrostomy (PEG) tubes in prolonging life for patients with advanced dementia, and seven years after the appearance of two articles in major medical journals arguing that tube feeding should no longer be the standard of care for individuals with advanced dementia, gastrostomy tubes remain commonplace in this population. One overlooked reason that many families and physicians continue to opt for artificial nutrition is that the case for feeding tubes is a moral one and not a scientific one. What may be at issue for families is how best to demonstrate caring, and caring is not readily amenable to empirical study. A better approach to family members who want feeding tubes for the demented is to acknowledge the symbolic value of nutrition for them and to seek an alternative means of satisfying the need to feed.

A Percutaneous Endoscopic Gastrostomy Tube Pushed Through the Posterior Wall of the Stomach as far as the Pancreas During Nonendoscopic Tube Exchange

The safety and efficacy of percutaneous endoscopic gastrostomy (PEG) have been well documented [1] [2]. With regard to the removal of PEG tubes, the standard method used recently has been nonendoscopic removal: the percutaneous removal method should cost less and be less time-consuming because it obviates the need for an endoscopy. However, complications arising from such PEG tube exchange procedures have been reported [3] [4]. We encountered a patient who developed problems as a result of a PEG tube exchange, in whom it was discovered that the the PEG tube had gone through the posterior wall of the stomach, reaching as far as the anterior aspect of the pancreas.

Percutaneous Endoscopic Gastrostomy in ICU Patients with Previous Laparotomy

To our knowledge, there is an absence of data evaluating the safety and efficacy of percutaneous endoscopic gastrostomy (PEG) placement in ICU patients with previous abdominal surgery. Our goals were to determine the complication rate of PEG in ICU patients who either had a recent or prior laparotomy compared to patients without any prior abdominal surgery. Prospective data was collected on 42 consecutive patients with prior abdominal surgery who underwent PEG placement in a university ICU setting during a 3-year period. These patients were further stratified by time of previous abdominal surgery: recent = abdominal surgery during the current hospitalization; old = abdominal surgery done prior to the current hospitalization and >30 days. Complications were defined as technical problems, local infection, tube dislodgment, and bleeding. This data was compared to results of 75 consecutive PEG placements in ICU patients with no previous abdominal surgery (NPAS) at the same institution. A total of 117 patients were included in the study. Sixty-two (58%) of the patients were trauma patients and 45 (42%) had other pathology. The mean age of the study population was 53 +/- 15 years and they were primarily male (75%). The overall complication rates were as follows: local wound = 18.7 per cent, technical problems = 4 per cent, PEG dislodgment = 7.4 per cent, and bleeding = 3 per cent. Of the 42 patients with prior abdominal surgery, 22 were recent, and 20 were old. Local wound complications were the most common complication when stratified by PEG category (virgin = 17.3%, recent = 18%, and old = 15%) followed by dislodgment (virgin = 6.7%, recent = 9%, and old = 5%). There were no significant differences in complication rates when comparing specific complications by PEG category as analyzed by chi2 analysis. PEG should be considered in all patients with previous laparotomy in need for long-term enteral access.

高齢脳血管障害患者における経皮内視鏡的胃瘻造設術の有用性 : 長期栄養管理と機能予後に関する検討

高齢脳血管障害患者に対する長期栄養管理における経皮内視鏡的胃掻造設術(percutaneous endoscopic gastrostomy ; PEG)の有用性について,従来の中心静脈栄養法,経鼻的経管栄養法と比較検討した.対象は70歳以上の脳血管障害患者で,経口摂取による栄養摂取が不十分となった94例である.Push法によりPEGを作成し,3日目より経管栄養剤の投与を開始した.PEG作成に伴う死亡例はみられず,合併症として創部出血,チユーブの自己抜去,感染,誤嚥性肺炎がみられた.PEGからの経管栄養剤の投与により,血清アルブミン値の有意な改善を認め,嚥下機能改善,褥瘡予防,身の目り動作を中心としたADLの改善に有効であった.高齢脳血管障害患者における長期栄養管理および機能予後改善において,PEGは従来の中心静脈栄養法,経鼻的経管栄養法に比べ,有用な方法であると考えられた.

Safety and efficacy of percutaneous endoscopic gastrostomy in children : O.E. Marin, M.S. Glassman, B.T. Schoen, et al. Am J Gastroenterol 89:357–363, (March), 1994

Safety and efficacy of percutaneous endoscopic gastrostomy in children : O.E. Marin, M.S. Glassman, B.T. Schoen, et al. Am J Gastroenterol 89:357–363, (March), 1994

Safety and efficacy of percutaneous endoscopic gastrostomy in children O E MARIN, M S GLASSMAN, B T SCHOEN, ET AL Emory University School of Medicine, Atlanta

Nutrition in Clinical PracticeVolume 9, Issue 5 p. 202-202 Article Safety and efficacy of percutaneous endoscopic gastrostomy in children O E MARIN, M S GLASSMAN, B T SCHOEN, ET AL Emory University School of Medicine, Atlanta Carolyn Viall, Carolyn ViallSearch for more papers by this author Carolyn Viall, Carolyn ViallSearch for more papers by this author First published: 01 October 1994 https://doi.org/10.1177/088453369400900512AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume9, Issue5October 1994Pages 202-202 RelatedInformation