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[Percutaneous endoscopic gastrostomy in patients with neurological diseases. Results of a prospective multicenter and international study].
Acta Gastroenterol Latinoam. 2004; 34(3):127-32.AG

Abstract

AIM

To determine prospectively the long-term evolution of patients with neurological diseases after insertion of percutaneous endoscopic gastrostomy (PEG).

METHODS

109 PEG were performed in 99 consecutive patients (49 females, 50 males), mean age 75 years (range: 20-97 years) as an alternative to a nasogastric tube. Patients were enterally fed because of chronic neurological swallowing difficulties: cerebrovascular disease 38, dementia 27, disordered swallowing mechanisms in elderly patients 10, motor neurona disease and multiple sclerosis 10, neuro-surgical disease 6, Parkinson's disease 3, brain tumor 3, neo-natal encephalopathy 1, HIV encephalopathy 1. The procedure took place in a dedicated endoscopy room. In all cases, prophylatic antibiotics were given and the PEG tube was inserted by the "pull" technique.

RESULTS

PEG insertion was technically succesful in all cases. After PEG insertion, all patients were subsequently discharged to local nursing home facilities. 85/99 patients were long-term followed-up on an outpatient basis, 25% of them were followed for more than a year. The mean follow-up time was 3 months (range: 1-24 months). The most frequent complication were minor: local wound infection 6, ostomy leakage 8, silicon degradation 16, leading to the removal of the PEG and the placement of a new PEG tubes in 10 cases. Two major complications were observed : one gastric perforation and death 2 months after the PEG placement and one gastrocolic fistula. No aspiration pneumonia was reported. In one patient, PEG was removed after recuperation of a normal swallowing. All patients had a nutritional improvement. A total of 11 deaths occurred during the follow-up, related to the neurological disorder in 10/11 cases. Nursing home team, patient's physicians and patient's families found PEG manipulations easier than naso-gastric tube.

CONCLUSION

Our study suggests that PEG is a method of choice for enteral feeding of patients with chronic neurological disorders. PEG is well-tolerated, leading to an improvement in nutritional status and offering good facilities for home nursing.

Authors+Show Affiliations

División de Gastroenterología, Hospital "Juan A. Fernández" del GCBA, Buenos Aires, Argentina. azalar@intramed.net.arNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article
Multicenter Study

Language

spa

PubMed ID

15742927

Citation

Zalar, Alberto E., et al. "[Percutaneous Endoscopic Gastrostomy in Patients With Neurological Diseases. Results of a Prospective Multicenter and International Study]." Acta Gastroenterologica Latinoamericana, vol. 34, no. 3, 2004, pp. 127-32.
Zalar AE, Guédon C, Piskorz EL, et al. [Percutaneous endoscopic gastrostomy in patients with neurological diseases. Results of a prospective multicenter and international study]. Acta Gastroenterol Latinoam. 2004;34(3):127-32.
Zalar, A. E., Guédon, C., Piskorz, E. L., Sánchez Basso, A., & Ducrotté, P. (2004). [Percutaneous endoscopic gastrostomy in patients with neurological diseases. Results of a prospective multicenter and international study]. Acta Gastroenterologica Latinoamericana, 34(3), 127-32.
Zalar AE, et al. [Percutaneous Endoscopic Gastrostomy in Patients With Neurological Diseases. Results of a Prospective Multicenter and International Study]. Acta Gastroenterol Latinoam. 2004;34(3):127-32. PubMed PMID: 15742927.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Percutaneous endoscopic gastrostomy in patients with neurological diseases. Results of a prospective multicenter and international study]. AU - Zalar,Alberto E, AU - Guédon,Claire, AU - Piskorz,Eduardo L, AU - Sánchez Basso,Adalberto, AU - Ducrotté,Philippe, PY - 2005/3/4/pubmed PY - 2005/8/19/medline PY - 2005/3/4/entrez SP - 127 EP - 32 JF - Acta gastroenterologica Latinoamericana JO - Acta Gastroenterol Latinoam VL - 34 IS - 3 N2 - AIM: To determine prospectively the long-term evolution of patients with neurological diseases after insertion of percutaneous endoscopic gastrostomy (PEG). METHODS: 109 PEG were performed in 99 consecutive patients (49 females, 50 males), mean age 75 years (range: 20-97 years) as an alternative to a nasogastric tube. Patients were enterally fed because of chronic neurological swallowing difficulties: cerebrovascular disease 38, dementia 27, disordered swallowing mechanisms in elderly patients 10, motor neurona disease and multiple sclerosis 10, neuro-surgical disease 6, Parkinson's disease 3, brain tumor 3, neo-natal encephalopathy 1, HIV encephalopathy 1. The procedure took place in a dedicated endoscopy room. In all cases, prophylatic antibiotics were given and the PEG tube was inserted by the "pull" technique. RESULTS: PEG insertion was technically succesful in all cases. After PEG insertion, all patients were subsequently discharged to local nursing home facilities. 85/99 patients were long-term followed-up on an outpatient basis, 25% of them were followed for more than a year. The mean follow-up time was 3 months (range: 1-24 months). The most frequent complication were minor: local wound infection 6, ostomy leakage 8, silicon degradation 16, leading to the removal of the PEG and the placement of a new PEG tubes in 10 cases. Two major complications were observed : one gastric perforation and death 2 months after the PEG placement and one gastrocolic fistula. No aspiration pneumonia was reported. In one patient, PEG was removed after recuperation of a normal swallowing. All patients had a nutritional improvement. A total of 11 deaths occurred during the follow-up, related to the neurological disorder in 10/11 cases. Nursing home team, patient's physicians and patient's families found PEG manipulations easier than naso-gastric tube. CONCLUSION: Our study suggests that PEG is a method of choice for enteral feeding of patients with chronic neurological disorders. PEG is well-tolerated, leading to an improvement in nutritional status and offering good facilities for home nursing. SN - 0300-9033 UR - https://www.unboundmedicine.com/medline/citation/15742927/[Percutaneous_endoscopic_gastrostomy_in_patients_with_neurological_diseases__Results_of_a_prospective_multicenter_and_international_study]_ L2 - https://medlineplus.gov/neurologicdiseases.html DB - PRIME DP - Unbound Medicine ER -