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Percutaneous endoscopic gastrostomy--indications and outcome of our experience at the Singapore General Hospital.
Singapore Med J. 2001 Oct; 42(10):460-5.SM

Abstract

INTRODUCTION

Percutaneous endoscopic gastrostomy (PEG) is widely used for patients with dysphagia from neurological causes and head and neck malignancy. We examined the indications, complication rates and long term outcome of PEG inserted in our department.

METHODS

We performed a study of PEG inserted in our department between January 1995 to March 2000. Consecutive patients with PEG inserted during this period were identified from our database that contained demographic data, primary and secondary underlying medical conditions, and immediate complications after the procedure. Casenotes were reviewed and caregivers (relatives or staff at nursing homes) were contacted for information on long term outcome at the time of this study between April 2000. Data was collected in standard form designed for this study.

RESULTS

181 cases of PEG insertion were performed during the study period. 174 patients were successfully followed up and reviewed. The median age was 70.5 (range 24 to 93) years old and there were 111 males. Indications for PEG insertion were: cerebrovascular diseases (60.4%), Parkinson's disease and other neuromuscular disorders (10.9%), nasopharyngeal carcinoma and other upper gastrointestinal malignancies (24.7%), and head injury (4%). Superficial wound infection (22.4%) and granuloma formation (31%) were common minor complications. Major complications were infrequent: peritonitis (2.3%) and gastrointestinal bleeding (0.6%). The mortality rates were 11.5% and 28.2% at one and six months respectively. Only one death from peritonitis was directly attributed to the procedure, most deaths were due to underlying co-morbidities with pneumonia being the most common cause. The proportion of the first PEG tubes removed or replaced were 12.2% and 35.5% at one and six months respectively. Thirty tubes were replaced due to blockage at median interval of 9.6 months. 9.7% of PEG tubes functioned longer than 24 months.

CONCLUSIONS

Our results confirm the safety of PEG tubes in elderly patients with multiple co-morbidities. Major complications of the procedure were infrequent but produced grave consequences in these elderly patients with multiple co-morbidities. As such, patients considered for PEG feeding should have reasonable prognosis and the procedure is inappropriate for patients with rapidly progressive and incurable diseases.

Authors+Show Affiliations

Department of Gastroenterology, Singapore General Hospital, Singapore. gm2wid@sgh.gov.sgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11874149

Citation

Luman, W, et al. "Percutaneous Endoscopic Gastrostomy--indications and Outcome of Our Experience at the Singapore General Hospital." Singapore Medical Journal, vol. 42, no. 10, 2001, pp. 460-5.
Luman W, Kwek KR, Loi KL, et al. Percutaneous endoscopic gastrostomy--indications and outcome of our experience at the Singapore General Hospital. Singapore Med J. 2001;42(10):460-5.
Luman, W., Kwek, K. R., Loi, K. L., Chiam, M. A., Cheung, W. K., & Ng, H. S. (2001). Percutaneous endoscopic gastrostomy--indications and outcome of our experience at the Singapore General Hospital. Singapore Medical Journal, 42(10), 460-5.
Luman W, et al. Percutaneous Endoscopic Gastrostomy--indications and Outcome of Our Experience at the Singapore General Hospital. Singapore Med J. 2001;42(10):460-5. PubMed PMID: 11874149.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percutaneous endoscopic gastrostomy--indications and outcome of our experience at the Singapore General Hospital. AU - Luman,W, AU - Kwek,K R, AU - Loi,K L, AU - Chiam,M A, AU - Cheung,W K, AU - Ng,H S, PY - 2002/3/5/pubmed PY - 2002/4/24/medline PY - 2002/3/5/entrez SP - 460 EP - 5 JF - Singapore medical journal JO - Singapore Med J VL - 42 IS - 10 N2 - INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) is widely used for patients with dysphagia from neurological causes and head and neck malignancy. We examined the indications, complication rates and long term outcome of PEG inserted in our department. METHODS: We performed a study of PEG inserted in our department between January 1995 to March 2000. Consecutive patients with PEG inserted during this period were identified from our database that contained demographic data, primary and secondary underlying medical conditions, and immediate complications after the procedure. Casenotes were reviewed and caregivers (relatives or staff at nursing homes) were contacted for information on long term outcome at the time of this study between April 2000. Data was collected in standard form designed for this study. RESULTS: 181 cases of PEG insertion were performed during the study period. 174 patients were successfully followed up and reviewed. The median age was 70.5 (range 24 to 93) years old and there were 111 males. Indications for PEG insertion were: cerebrovascular diseases (60.4%), Parkinson's disease and other neuromuscular disorders (10.9%), nasopharyngeal carcinoma and other upper gastrointestinal malignancies (24.7%), and head injury (4%). Superficial wound infection (22.4%) and granuloma formation (31%) were common minor complications. Major complications were infrequent: peritonitis (2.3%) and gastrointestinal bleeding (0.6%). The mortality rates were 11.5% and 28.2% at one and six months respectively. Only one death from peritonitis was directly attributed to the procedure, most deaths were due to underlying co-morbidities with pneumonia being the most common cause. The proportion of the first PEG tubes removed or replaced were 12.2% and 35.5% at one and six months respectively. Thirty tubes were replaced due to blockage at median interval of 9.6 months. 9.7% of PEG tubes functioned longer than 24 months. CONCLUSIONS: Our results confirm the safety of PEG tubes in elderly patients with multiple co-morbidities. Major complications of the procedure were infrequent but produced grave consequences in these elderly patients with multiple co-morbidities. As such, patients considered for PEG feeding should have reasonable prognosis and the procedure is inappropriate for patients with rapidly progressive and incurable diseases. SN - 0037-5675 UR - https://www.unboundmedicine.com/medline/citation/11874149/Percutaneous_endoscopic_gastrostomy__indications_and_outcome_of_our_experience_at_the_Singapore_General_Hospital_ L2 - https://medlineplus.gov/swallowingdisorders.html DB - PRIME DP - Unbound Medicine ER -