Percutaneous endoscopic gastrostomy. What are the benefits, what are the risks?
One way to nutritionally support patients who cannot swallow is to administer formula directly into the stomach. Placing a gastrostomy tube percutaneously using endoscopy avoids the risks of general anesthesia and wound healing that accompany surgical gastrostomy. Although certain conditions (eg, sepsis, coagulation disorder, portal hypertension) are contraindications to the procedure, it can be done in patients who have had previous abdominal surgery and in those with severe illness. A commercially available feeding formula is used. The type chosen and the frequency of administration are based on the patient's specific needs. With regular medical monitoring and daily care of the gastrostomy site, appropriately selected patients may be safely maintained with enteral feeding for months. An advantage of the percutaneously inserted tube is that it is easily removed when the patient regains the ability to eat, and the fistula heals rapidly.
DiLorenzo
J
J
Cornell University Medical College, New York, NY 10021-4885.
Dalton
B
B
Miskovitz
P
P
D004750:Enteral Nutrition; D005773:Gastroscopy; D005774:Gastrostomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans