Consensus Statement; ESPEN guidelines on Artificial enteral nutrition - percutaneous endoscopic gastrostomy (PEG)

Löser, Chr.; Aschl, G; Hébuterne, Xavier; Mathus-Vliegen, Elisabeth M. H.; Muscaritoli, Maurizio; Niv, Yaron; Rollins, Hazel; Singer, P.; Skelly, Robert

doi:10.1016/j.clnu.2005.06.013

Cited by 485 publications

(155 citation statements)

References 83 publications

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“…Tube feeding during short periods is suitably achieved using a nasogastric tube. For enteral feeding during periods longer than three to four weeks, gastrostomy is the correct choice and has proven to be a successful procedure in patients unable to swallow (1). Furthermore, gastrostomy may also be used for drainage/ decompressive purposes for patients with subocclusive disorders.…”

Section: Introductionmentioning

confidence: 99%

The role of surgical gastrostomy in the age of endoscopic gastrostomy: a 13 years and 543 patients retrospective study

2016

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Background: Percutaneous endoscopic gastrostomy (PEG) became the gold standard for enteral feeding. Currently, surgical gastrostomy is seldom used.Objective: Evaluating the role of surgical gastrostomy in a center with a large experience in PEG.Methods: A retrospective study ranged 13 years, collecting from clinical records: age, gender, underlying disease, date of procedure, technique, primary surgery, complications, 30-day mortality. Patients were divided according to indication for gastrostomy: a) neurological; b) head and neck cancer; c) other diseases; and d) drainage. PEG, open surgical and laparoscopic gastrostomies were compared concerning evolution of the number of procedures, characteristics of patients, complications and mortality.Results: We identified 509 PEG, 26 open and 8 laparoscopic surgical gastrostomies. An increasing number of the percutaneous approach over the years was observed, while the number of surgical gastrostomies remains steady (mean: 2.6/year). All percutaneous endoscopic gastrostomies but three were feeding procedures, mostly in neurological patients. All laparoscopic gastrostomies were feeding procedures in head and neck cancer. Most open surgical gastrostomies were secondary procedures, part of more complex surgeries, and frequently for drainage purposes. The open surgical approach displayed more morbidity and mortality, reflecting the severity of underlying diseases.Conclusions: In our institution, open surgical gastrostomy is seldom used, and mostly as part of complex procedures, frequently for drainage purposes. PEG is the choice to most dysphagic patients needing an enteral feeding access. When not feasible, laparoscopic gastrostomy is a suitable alternative.

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Section: Introductionmentioning

confidence: 99%

The role of surgical gastrostomy in the age of endoscopic gastrostomy: a 13 years and 543 patients retrospective study

2016

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“…Even if the superiority of percutaneously placed gastrostomies compared to former surgical gastrostomy procedures (Witzel, Stamm, Janeway technique) has been shown clearly in many clinical studies [16], the surgical procedures are still frequently used; the placement of a gastrostomy seems to be justified in these special cases of complete esophageal obstructions due to malignancy, in order to provide easy access to the distal esophagus.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Malignant Esophageal Fistulas: Fluoroscopic Placement of Esophageal SEMS, Endoscopically-assisted through Surgical Gastrostomy. A Case Report

Constantinescu

Șandru

Ilie

et al. 2016

JGLD

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Progressive esophageal carcinoma can infiltrate the surrounding tissues with subsequent development of a fistula, most commonly between the esophagus and the respiratory tract. The endoscopic placement of covered self-expanding metallic stents (SEMS) is the treatment of choice for malignant esophageal fistulas and should be performed immediately, as a fistula formation represents a potential life-threatening complication. We report the case of a 64-year-old male diagnosed with esophageal carcinoma, who had a 20Fr surgical gastrostomy tube inserted before chemo- and radiotherapy and was referred to our department for complete dysphagia, cough after swallowing and fever. The attempt to insert a SEMS using the classic endoscopic procedure failed. Then, a fully covered stent was inserted, as the 0.035” guide wire was passed through stenosis retrogradely by using an Olympus Exera II GIF-N180 (4.9 mm in diameter endoscope) via surgical gastrostomy, with a good outcome for the patient. The retrograde approach via gastrostomy under endoscopic/fluoroscopic guidance with the placement of a fully covered SEMS proved to be the technique of choice, in a patient with malignant esophageal fistula in whom other methods of treatment were not feasible. Abbreviations: ERCP: endoscopic retrograde cholangio-pancreatography; GI: gastrointestinal; SEMS: self-expandable metallic stents.

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“…At the time of admission, the patient's cognitive function could not be measured. Although its use is controversial in dementia patients, percutaneous endoscopic gastrostomy17 was performed because she suddenly began to refuse oral intake in September 2015; this decision was based on the family's values and preferences. The patient's BPSD, including agitation and aggression, were slightly alleviated and she was transferred to the nonpsychiatric ward.…”

Section: Case Reportmentioning

confidence: 99%

Successful institutional care for behavioral and psychological symptoms of dementia in a repopulated area after the 2011 Fukushima disaster: A case report

Nishikawa

Niimura

Ozaki

et al. 2018

Clinical Case Reports

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Consensus Statement; ESPEN guidelines on Artificial enteral nutrition - percutaneous endoscopic gastrostomy (PEG)

Cited by 485 publications

References 83 publications

The role of surgical gastrostomy in the age of endoscopic gastrostomy: a 13 years and 543 patients retrospective study

The role of surgical gastrostomy in the age of endoscopic gastrostomy: a 13 years and 543 patients retrospective study

Treatment of Malignant Esophageal Fistulas: Fluoroscopic Placement of Esophageal SEMS, Endoscopically-assisted through Surgical Gastrostomy. A Case Report

Successful institutional care for behavioral and psychological symptoms of dementia in a repopulated area after the 2011 Fukushima disaster: A case report

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