Long-term management of percutaneous endoscopic gastrostomy by a nutritional support team

Cortez‐Pinto, Helena; Correia, A P; Camilo, M.E.; Tavares, L.; Moura, Miguel Carneiro de

doi:10.1054/clnu.2001.0499

Cited by 25 publications

(19 citation statements)

References 22 publications

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“…Operator experience is important; a single operator performed most of the procedures. Follow-up by a dedicated team of health-care personnel is likely to influence the outcome of the procedure [28]. Pre-procedural abnormality of respiratory function has an effect on patient survival; those patients with good respiratory reserve survive longer [29,30].…”

Section: Discussionmentioning

confidence: 99%

Mushroom-cage gastrostomy tube placement in patients with amyotrophic lateral sclerosis: a 5-year experience in 104 patients in a single institution

et al. 2009

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To review our experience of placement of a mushroom-cage gastrostomy tube (Entristar, Tyco Healthcare, Mansfield, MA), using radiological guidance, in patients with amyotrophic lateral sclerosis (ALS). All procedures were performed under local anaesthesia without sedation. Complications were recorded as peri-procedural, early (<24 h), late (>24 h), major or minor. Deaths were recorded as related to the underlying ALS or secondary to radiological-inserted gastrostomy (RIG) placement. Replacement RIG tube rate was recorded. Over a 5-year period RIG tubes were placed in 104 patients with ALS (male n = 52, female n = 52), with a median age of 62 years (range 34-86 years). All procedures were technically successful. Of the RIG procedures, 21/104 (20.2%) were performed with respiratory support. The 30-day mortality rate was 7/104 (6.7%); no patient died as a result of the procedure. There were 23/104 (22.1%) complications overall; 20/104 (19.2%) were minor and 3/104 (2.9%) major, requiring surgery (n = 2) and radiological-guided abscess drainage (n = 1). A median interval between replacement RIG procedures in 20/104 (19.2%) patients was 141.5 days (range 43-537 days). A mushroom-cage RIG tube may be safely and effectively inserted in a 'one-step' radiological procedure and may replace endoscopic-inserted gastrostomy tubes in the nutritional management of ALS.

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Section: Discussionmentioning

confidence: 99%

Mushroom-cage gastrostomy tube placement in patients with amyotrophic lateral sclerosis: a 5-year experience in 104 patients in a single institution

et al. 2009

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“…In the literature, procedure related mortality rate was reported to be between 1% and 3% [11,12]. The incidence of complications in previous series varied from 5% to 55% [11,[13][14][15]. Most studies have suggested that complications are more likely to occur in elderly patients with comorbid illnesses [16].…”

Section: Discussionmentioning

confidence: 99%

Short and long-term results of percutaneous endoscopic gastrostomy

Tuna¹,

Duman²

2012

CMJ

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Aim. Percutaneous endoscopic gastrostomy is the most common method of long-term enteral nutrition. The aim of this study is to evaluate the short and long term efficacy and complications of percutaneous endoscopic gastrostomy. Methods. We included 172 patients who underwent percutaneous endoscopic gastrostomy procedure between 2004 and 2010 in the Gastroenterology Clinic of Akdeniz University. Nutritional status was evaluated on the basis of albumin levels at the sixth month. Patients were evaluated for local and systemic complications of percutaneous endoscopic gastrostomy. Results. Sixty-nine (40.1%) patients who underwent percutaneous endoscopic gastrostomy procedures died due to their primary diseases. Percutaneous endoscopic gastrostomy was placed for stroke in 49 patients , for dementia in 32 patients, for posttraumatic encephalopathy in 53 patients, for post-anoxic encephalopathy in 6 patients, for malignant disorders in 30 patients , and for menigoencephalitis in 2 patients. Patients were evaluated for local and systemic percutaneous endoscopic gastrostomy tube complications. The systemic complications consisted of three cases with peritonitis, two bleeding episodes, nine cases with aspiration pneumonia, four cases with dislocation of catheter, and six cases with abscess of abdominal wall. The local complications consisted of seventeen cases with local wound erythema; fifteen patients had leakage of gastric contents, four cases with granuloma formation, and three cases with pain at percutaneous endoscopic gastrostomy site. Mean albumin level of patients at the six month was 3.2 gr/dL. Removal of percutaneous endoscopic gastrostomy due to return of ability to swallow was observed in ten patients. Conclusion. Percutaneous endoscopic gastrostomy is a safe and effective method which accesses to the gastrointestinal tract when performed according to the guidelines. Complications associated with percutaneous endoscopic gastrostomy are well described and are usually local, but major rare events require surgery or result in death. It is safe in terms of complications. Indications and introduction procedures should be standardized. Follow-up by a dietician or specialist nurse could potentially bridge the gap between primary care and hospitals. Keywords: Gastrostomy, indications, complications ÖzetAmaç. Perkutan endoskopik gastrostomi en sık kullanılan uzun dönem enteral beslenme metodudur. Bu çalışmanın amacı perkutan endoskopik gastrostominin kısa ve uzun dönem etkinliği ile komplikasyonlarını değerlendirmektir. Yöntemler. Çalışmaya Akdeniz Üniversitesi Gastroenteroloji Kliniği' nde 2004-2010 yılları arasında perkutan endoskopik gastrostomi takılmış 172 hasta dahil edildi. Hastaların beslenme yeterliliği 6. aydaki serum albumin düzeylerine göre değerlendirildi. Hastalar perkutan endoskopik gastrostominin lokal ve sistemik komplikasyonları açısından değerlendirildi. Bulgular. Perkutan endoskopik gastrostomi takılan hastaların 69(% 40.1)'unun ölümü primer hastalığına bağlıydı. Hastaların 49'una inme, 32'si...

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“…Total parenteral nütrisyonla karşılaş-tırıldığında ise genel enfeksiyon komplikasyonlarının az olması, santral venöz yol gerektirmemesi, daha ucuz olması ve hasta uyumunun daha iyi olması önemli avantajlarıdır [12]. Çoğun-lukla oral beslenme sağlanamayan nörolojik hastalarda uygulanmakla beraber sebep olduğu obstrüksiyon nedeniyle gıda geçişine izin vermeyen kanserlerde, uzamış entübasyonda ve aspirasyon pnömonisi riski yüksek olan hasta grubunda uygulanmaktadır [13,14]. Bizim hastalarımızın da %60'dan fazlasını nö-rolojik hasta grubu oluşturmaktadır.…”

Section: Gereç Ve Yöntemunclassified

Effect of Body Mass Index on Processing Time and Morbidity in Elderly Percutaneous Endoscopic Gastrostomy Patient

2016

Ann Clin Anal Med

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ÖzetAmaç: Oral yoldan beslenemeyen ancak gastrointestinal sistem fonksiyonları normal olan yaşlı hastalarda perkütan endoskopik gastrostomi (PEG) işle-minin güvenilirliğini değerlendirmek, hastaların vücut kitle indeksi (VKİ) ile iş-lem süresi ve komplikasyon oranları arasındaki ilişkiyi belirlemektir. Gereç ve Yöntem: 2011 Şubat ve 2014 Aralık ayları arasında çekme yöntemi ile yü-zeyel anestezi altında PEG yerleştirilen, 65 yaşın üstündeki 97 hastanın klinik verileri ve komplikasyon oranları retrospektif olarak incelendi. Tüm hastalar yaş, cins, PEG endikasyonları, komplikasyonlar, işlem süreleri, antibiyotik profilaksi uygulanması, vücut kitle indeksi (VKİ) ve takip süreleri açısından değerlendirildi. Bulgular: Çalışmamızda 51'i (%52,6) kadın, 46'sı(%47,4) erkek toplam 97 hasta mevcuttu. Yaş ortalaması 72 ± 4 idi. PEG endikasyonu olarak 41(%42) olguda serebrovasküler hastalıklar, 19(%19,5) olguda obstrük-siyon yapan malign hastalıklar, 16(%16,5) olguda demans ve 21(%22) olguda diğer hastalıklar saptandı. Vücut kitle indeksi ortalama 25±3(17-32)kg/m² olarak hesaplandı. Ortalama işlem süresi 8,6±1,6 dakika idi. VKİ 25'in üzerin-de olanlarda işlem sürelerinde istatistiksel anlamlı artış saptandı (p<0,05). Toplam 10(%10,2) hastada minör komplikasyon saptandı. 8(%8) olguda antibiyotik tedavisi gerektirecek yara çevresi enfeksiyonu, 2(%2) olguda kateter kenarından hafif sızdırma görüldü. VKİ 25'in üstünde olanlarda komplikasyon oranının istatistiksel anlamlı yüksek olduğu saptandı (p<0,05). Hastaların takip süresi 224(68-660) gün olup işleme ait mortalite saptanmamıştır. Tartışma: PEG, çeşitli nedenlerle oral yoldan beslenemeyen olgularda uzun süre-li ve en uygun beslenme desteği sağlayan güvenli bir yöntemdir. VKİ yüksek hastalarda, işlem sırasında komplikasyon riski açısından daha özenli uygulama gerekebilmektedir. Anahtar KelimelerGastrostomi; Enteral Beslenme; Endoskopi; Vücut Kitle İndeksi; Geriatrik Abstract Aim: We aimed to assess the reliability of percutaneous endoscopic gastrostomy (PEG) applications and to investigate the relationship between body mass index and duration of the procedure and complication rates of geriatric patients. Material and Method: Between 2011 February and 2014 December, we retrospectively analyzed the clinical data and complication rates of 97 geriatric patients to whom PEG was applied by the pull method under superficial anesthesia. All patients were evaluated in terms of age, sex, PEG indications, and complications, time of procedure, body mass index (BMI), antibiotic prophylaxis and follow up period. Results: 51(53%) of our patients were female and 46(47%) were male with a mean age of 72 ± 4. Cerebrovasculer disease was seen in 41(42%) cases, malign disease which cause an obstruction in 19(19,5%) cases, dementia in 16(16,5%) cases and other disease in 21(22%) cases as etiologic causes. The BMI of the patients were 25±3(17-32)kg/m². The mean time of duration of the procedure was 8,6±1,6 minute. It was found statistically significance between BMI (up to 25 kg/m²) and prolonged dur...

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Long-term management of percutaneous endoscopic gastrostomy by a nutritional support team

Cited by 25 publications

References 22 publications

Mushroom-cage gastrostomy tube placement in patients with amyotrophic lateral sclerosis: a 5-year experience in 104 patients in a single institution

Mushroom-cage gastrostomy tube placement in patients with amyotrophic lateral sclerosis: a 5-year experience in 104 patients in a single institution

Short and long-term results of percutaneous endoscopic gastrostomy

Effect of Body Mass Index on Processing Time and Morbidity in Elderly Percutaneous Endoscopic Gastrostomy Patient

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