مرکز منطقه ای اطلاع رساني علوم و فناوري - Short and long-term results of percutaneous endoscopic gastrostomy

Abstract :

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.