JOCS
Journal of Comprehensive Surgery

The aim of the Comprehensive Surgery is to publish original research articles of the highest scientific and clinical value at the international level in all surgical fields. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

eISSN: 2980-0862
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
Retrospective analysis of percutaneous endoscopic gastrostomy cases in the endoscopy unit
Abstract
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.

Keywords : Enteral nutrition, gastrostomy, gastric feeding tubes, endoscopic surgical procedure

Download Article


1. Dietrich CG, Schoppmeyer K. Percutaneous endoscopic gastrostomy-too often? too late? who are the right patients for gastrostomy? World JGastroenterol. 2020;26(20):2464.
2. De Sousa Magalhães R, Cúrdia Gonçalves T, Sousa-Pinto B, Rosa B,Marinho C, Cotter J. Percutaneous endoscopic gastrostomy: dealingwith the issue of dislodgement. Scand J Gastroenterol. 2020;55(4):485-91.
3. Haqqi S, Farrukh S, Dhedhi AS, Siddiqui AR, Muhammad AJ, Niaz SK.Percutaneous endoscopic gastrostomy; success and outcome of a novelmodality for enteral nutrition. J Pak Med Assoc. 2020;70:1795-8.
4. Villalba CM, Rodríguez JAV, Sánchez FG. Percutaneous endoscopicgastrostomy. Indications, care and complications. Medicina Clínica(English Edition). 2019;152(6):229-36.
5. Arvanitakis M, Gkolfakis P, Despott EJ, et al. Endoscopic managementof enteral tubes in adult patients-Part 1: Definitions and indications.European Society of Gastrointestinal Endoscopy (ESGE) Guideline.Endoscopy. 2021;53(01):81-92.
6. Weimann A, Braga M, Carli F, et al. ESPEN practical guideline: Clinicalnutrition in surgery. Clin Nutr. 2021;40(7):4745-61.
7. Gauderer MW, Ponsky JL, Izant Jr RJ. Gastrostomy without laparotomy:a percutaneous endoscopic technique. J Pediatr Surg. 1980;15(6):872-5.
8. Ponsky JL. The development of PEG: how it was. J InterventGastroenterol 2011;1(2), 88.
9. Temiz A, Aslan OB, Albayrak Y, ALBAYRAK F, Kısaoğlu A, Er S.Perkütan endoskopik gastrostomi: endikasyon ve komplikasyonlar.Akademik Gastroenteroloji Dergisi. 2015;14(3):113-6.
10. Coşkun O. Perkütan endoskopik gastrostomi uygulamasındakisonuçlarımız: 58 olgunun değerlendirilmesi. EndoskopiGastrointestinal. 2019;27(3):93-6.
11. Löser C, Aschl G, Hébuterne X, et al. ESPEN guidelines on artificialenteral nutrition--percutaneous endoscopic gastrostomy (PEG). ClinNutr. 2005;24(5):848-61.
12. Itkin M, DeLegge MH, Fang JC, et al. Multidisciplinary practicalguidelines for gastrointestinal access for enteral nutrition anddecompression from the Society of Interventional Radiology andAmerican Gastroenterological Association (AGA) Institute, withendorsement by Canadian Interventional Radiological Association(CIRA) and Cardiovascular and Interventional Radiological Society ofEurope (CIRSE). Gastroenterology. 2011;141(2):742-65.
13. Fugazza A, Capogreco A, Cappello A, et al. Percutaneous endoscopicgastrostomy and jejunostomy: Indications and techniques. WorldJ Gastrointest Endosc. 2022;14(5):250-266. doi:10.4253/wjge.v14.i5.250
14. Akıcı M, Erşen O, Çelik G, Çilekar M. Experiences with percutaneousendoscopic gastrostomy in a general surgery clinic. SDÜ Tıp FakültesiDergisi. 2019;26(3):234-8.
15. Rahnemai-Azar AA, Rahnemaiazar AA, Naghshizadian R, KurtzA, Farkas DT. Percutaneous endoscopic gastrostomy: indications,technique, complications and management. World J Gastroenterol.2014;20(24):7739-7751. doi:10.3748/wjg.v20.i24.7739
16. Mekhail TM, Adelstein DJ, Rybicki LA, Larto MA, Saxton JP, Lavertu P.Enteral nutrition during the treatment of head and neck carcinoma: isa percutaneous endoscopic gastrostomy tube preferable to a nasogastrictube? Cancer. 2001;91:1785-1790.
17. Park RH, Allison MC, Lang J, et al. Randomised comparison ofpercutaneous endoscopic gastrostomy and nasogastric tube feeding inpatients with persisting neurological dysphagia. BMJ. 1992;304:1406-1409.
18. Baeten C, Hoefnagels J. Feeding via nasogastric tube or percutaneousendoscopic gastrostomy. A comparison. Scand J Gastroenterol Suppl.1992;194:95-98.
19. Gomes CA Jr, Andriolo RB, Bennett C, et al. Percutaneous endoscopicgastrostomy versus nasogastric tube feeding for adults with swallowingdisturbances. Cochrane Database Syst Rev. 2015;2015(5):CD008096.doi:10.1002/14651858.CD008096.pub4
20. Pearce CB, Duncan HD. Enteral feeding. Nasogastric, nasojejunal,percutaneous endoscopic gastrostomy, or jejunostomy: its indicationsand limitations. Postgrad Med J. 2002;78(918):198-204. doi:10.1136/pmj.78.918.198
Article available in :
Volume 1, Issue 2, 2023
Page : 26-29
https://doi.org/10.51271/JOCS-0007
Article Information
Received : 03 Nis 2023
Accepted : 25 Nis 2023
Published : 28 May 2023
Corresponding Author :

Tezcan Akın: Ankara City Hospital, Department of General Surgery, Ankara, Turkey

[email protected]
Citation : Akın T, Çetinkaya E, Göktaş A, et al. Retrospective analysis of percutaneous endoscopic gastrostomy cases in the endoscopy unit. J Compr Surg. 2023;1(2):26-29.

Read: 273
Cited: 0
Download : 185
_Footer