[Enteral alimentation at home: why PEG now?].
The history of percutaneous endoscopic gastrostomy (PEG) is relatively short. In 1980, a report entitled "Gastrostomy without laparotomy: A percutaneous endoscopic technique" by Ponsky and Gaudere was first published in the Journal of Pediatric Surgery. Thereafter, PEG soon saw widespread use in Western countries because of its clinical efficacy and economy. It has been performed in about 170,000 cases annually in the US. In contrast, its spread in Japan has been extremely slow: only about 10,000 cases have undergone this procedure annually, and this number accounted for less than 5% of patients receiving enteral alimentation. The reason why PEG has not spread may be the medical insurance system in Japan and the local distaste for operation scarring. However, in consideration of the unprecedented ageing of society that is surely coming in the near future, the role of PEG in Japan must be reexamined. In this report, we presented the methodology of enteral alimentation at home by means of PEG, giving special consideration to: (1) "What points are improved by using enteral alimentation at home by means of PEG in various diseases; (2) dysphagia due to cerebral angiopathy; (3) terminal cancer; (4) otolaryngological diseases; and (5) Crohn disease. We also discussed "Why PEG is important now?" in performing enteral alimentation at home.
Suzuki
Y
Y
Second Dept. of Surgery, Jikei University School of Medicine.
Hanyu
N
N
Kashiwagi
H
H
Kubo
T
T
Aoki
T
T
D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000451:nursing; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D009369:Neoplasms / Q000451:nursing; D010038:Otorhinolaryngologic Diseases / Q000451:nursing; D016331:Parenteral Nutrition, Home / Q000379:methods; D010349:Patient Compliance; D010353:Patient Education as Topic; D013727:Terminal Care