Percutaneous endoscopic gastrostomy; success and outcome of a novel modality for enteral nutrition

Haqqi, Syed Afzal Ul Haq; Farrukh, Syed Zea Ul Islam; Dhedhi, Abdul Samad; Siddiqui, Arif Rasheed; Muhammad, Asif Jan; Niaz, Saad Khalid

doi:10.5455/jpma.30413

Cited by 5 publications

(4 citation statements)

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“…19 Dysphagic patients and patients with anorexia, malabsorption, or excessive catabolism may also need long-term enteral nutrition. 19,20 In a PEG series of 367 patients by Haggi et al 3 the most common indication for tube placement was neurological dysphagia in 259 (70.6%) patients and cerebrovascular accident in 212 (81.9%) of them. In addition, other indications were reported to be oropharyngeal tumors (64; 17.4%), laryngeal tumors (31; 8.4%), esophageal tumors (9; 2.5%), and esophageal fistula (4; 1.1%).…”

Section: Discussionmentioning

confidence: 99%

“…Now, PEG is widely acknowledged as the most efficient way to provide long-term nutritional support. 2, 3 It is a safe and effective method, offering some advantages over the nasoenteral route to ensure the delivery of nutrients to the digestive system in patients with difficulty in oral consumption of food and liquids. 4 However, enteral nutrition may not be provided efficiently in a number of conditions leading to passage problems (e.g., larynx, esophagus, and stomach cancers) or causing dysphagia (e.g., genetic diseases, cerebrovascular accident, head trauma, brain tumor, and amyotrophic lateral sclerosis).…”

Section: Introductionmentioning

confidence: 99%

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Retrospective Analysis of Percutaneous Endoscopic Gastrostomy Cases in the Endoscopy Unit

Akın¹,

Çetinkaya²,

Göktaş³

et al. 2023

JOCS

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Aims: Enteral nutrition is considered a primary, first-choice nutrition method when the passage in the gastrointestinal tract is open. The present study attempted to present the experience of percutaneous endoscopic gastrostomy performed in our endoscopy unit. Methods: This study investigated the data of 39 patients undergoing the placement of a percutaneous endoscopic gastrostomy (PEG) catheter in our endoscopy unit between July 2019 and November 2020. A team of experienced specialists, assistant physicians, and nurses performed the procedure at the bedside for patients intubated in the intensive care unit or with a poor general condition or in the endoscopy unit for other patients after being sedated by the anesthesiologist. The patients were started to be fed through the PEG catheter with an initial dose of 10 cc/hour, correlated with the clinical nutrition unit, at the 6th and 12th hours following the procedure, and the dose was gradually increased to the target dose. The patients’ data were presented as frequencies and percentages (%). Results: The data of 39 patients, 17 (44%) females and 22 (56%) males, were retrospectively investigated in this study. The median age of the patients was found to be 67 years (21-102 years). While 32 patients were hospitalized in the intensive care unit, four received palliative care, and three were followed up in the clinic wards. Considering the pathologies leading to the indication of PEG catheter placement, 15 patients had Cerebrovascular disease, 12 had Alzheimer’s disease, 4 had absent swallow reflex, 3 had a subarachnoid hemorrhage, 2 had a hypoxic brain, 1 had spastic cerebral palsy, 1 had Sanfilippo syndrome, and 1 had oral feeding intolerance. No complications developed in any of the patients during the procedure. While 24 patients were discharged, mortality developed in 15 during hospitalization due to primary pathology. Conclusion: Contemporarily, a key requirement for optimal treatment is adequate nutrition, and the superiority of enteral nutrition is indisputable in providing such nutrition. PEG is known to be a more efficient method in long-term nutrition when compared to other enteral feeding methods. In conclusion, PEG can be performed for relevant patients with low complication rates in general surgery endoscopy units.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Retrospective Analysis of Percutaneous Endoscopic Gastrostomy Cases in the Endoscopy Unit

Akın¹,

Çetinkaya²,

Göktaş³

et al. 2023

JOCS

View full text Add to dashboard Cite

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“…Another rare but recognized indication is to deliver therapeutic formulae in patients with certain metabolic disorders, which are usually unpalatable. Finally, it can be offered to patients who require many medications due to other organ diseases to improve compliance and effectiveness of medications[ 6 - 8 ].…”

Section: Indications and Contraindicationsmentioning

confidence: 99%

Advances and challenges of gastrostomy insertion in children

Bitar,

Azaz,

Rawat

et al. 2023

World J Gastrointest Surg

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Indocyanine green (ICG) is a water-soluble fluorescent dye that is minimally toxic and widely used in gastrointestinal surgery. ICG facilitates anatomical identification of structures (e.g., ureters), assessment of lymph nodes, biliary mapping, organ perfusion and anastomosis assessment, and aids in determining the adequacy of oncological margins. In addition, ICG can be conjugated to artificially created antibodies for tumour markers, such as carcinoembryonic antigen for colorectal, breast, lung, and gastric cancer, prostate-specific antigen for prostate cancer, and cancer antigen 125 for ovarian cancer. Although ICG has shown promising results, the optimization of patient factors, dye factors, equipment, and the method of assessing fluorescence intensity could further enhance its utility. This review summarizes the clinical application of ICG in gastrointestinal surgery and discusses the emergence of novel dyes such as ZW-800 and VM678 that have demonstrated appropriate pharmacokinetic properties and improved target-to-background ratios in animal studies. With the emergence of robotic technology and the increasing reporting of ICG utility, a comprehensive review of clinical application of ICG in gastrointestinal surgery is timely and this review serves that aim.

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“…PEG feeding can be used when oral food intake, despite undisturbed swallowing, does not provide sufficient energy support to the body. PEG can also be placed in patients with maxillary injury, patients with mental disabilities, and patients who are in a permanent vegetative state or near the end of life [9]. On the other hand, contraindications for PEG placement are: serious coagulation disorders, hemodynamic instability, sepsis, severe ascites, peritonitis, abdominal wall infection at the placement site, peritoneal carcinomatosis, lack of a safe tract for percutaneous insertion, gastric outlet obstruction, severe gastroparesis, history of total gastrectomy, prolonged ventilation assistance and lack of informed consent [5].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Endoscopic Gastrostomy Tubes Can Be Considered Safe in Children: A Single-Center 11-Year Retrospective Analysis

et al. 2021

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Background and Objectives: When the human body is disabled to naturally ingest food through the mouth, enteral or parenteral nutritional support should be started. Percutaneous gastrostomy (PEG) is a flexible feeding tube that is inserted into the stomach through the abdominal wall in patients who will need long-term enteral nutrient intake. The aim of this study is to analyze clinical characteristic of children at the time of PEG placement as well as to determine indications, complications and outcomes associated with PEG at the Department of Pediatrics of the University Hospital of Split. Materials and Methods: Retrospective analysis of the medical records of patients treated from 2010 to 2020 was performed. The following data were collected from medical records: age, gender, information about nasogastric feeding before PEG placement, indication for PEG insertion, duration of PEG, procedure-related complications and treatment outcomes. Malnutrition was determined according to the z-score range for BMI for age and sex. According to the indication for PEG placement, patients were divided into five categories: central nervous system (CNS) diseases, neuromuscular diseases, genetic disorders, metabolic diseases, and group of children with polytrauma. Results: A total of 40 patients with median age of 110 months were included in study. At the time of PEG placement, most patients had deviations in body weight and height compared to expected values for age and sex. The most common underlying diagnoses were diseases of the central nervous system. Minor complications were found in 13 (35%) of patients. One patient (2.7%) developed major complication (gastrocolic fistula) and consequently underwent reoperation. The median duration of PEG in patients with complications before the need for replacement was 27 months, and in patients without complications, 43 months. Conclusions: Negative deviations of z-score body weight, body height, and body mass index could indicate the need for possible earlier placement of PEG. PEG can be considered as a safe therapeutic option in children since PEG-related complications, mostly in minor forms, were found in a small number of patients.

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Percutaneous endoscopic gastrostomy; success and outcome of a novel modality for enteral nutrition

Cited by 5 publications

References 0 publications

Retrospective Analysis of Percutaneous Endoscopic Gastrostomy Cases in the Endoscopy Unit

Retrospective Analysis of Percutaneous Endoscopic Gastrostomy Cases in the Endoscopy Unit

Advances and challenges of gastrostomy insertion in children

Percutaneous Endoscopic Gastrostomy Tubes Can Be Considered Safe in Children: A Single-Center 11-Year Retrospective Analysis

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