Patient with percutaneous endoscopic gastrostomy.
BACKGROUND
Since 1980, when percutaneous endoscopic gastrostomy was described and performed for the first time, the number of patients with this way of nutrition has been growing. At present, however, these patients are treated not only in intensive care units, but also in follow-up care institutions or in home care.


OBJECTIVE
We want to explain the problems of nutrition via endoscopic gastrostomy to those physicians who take long-term care of these patients.


METHODS
In our department we introduced percutaneous endoscopic gastrostomy in 1994. A total of 78 PEGs were performed. In all cases the pull technique was used. A condition for percutaneous endoscopic gastrostomy insertion was an unaffected gastrointestinal tract from the stomach in aboral direction. The most frequent indications were: necessity of long-term enteral nutrition in patients during artificial ventilation, neurological patients with lost swallowing reflex, and patients with a tumor in the ENT area with preserved patency for the endoscope.


RESULTS
In all cases, the intervention itself was without major complications and no death occurred relating to the intervention. Subsequently, mainly local complications such as decubitus ulcers or maceration around the tube and its accidental removal by a restless patient were noticed.


CONCLUSIONS
In cases of more than 6-week inability to ingest food per os with otherwise unaffected gastrointestinal tract, it is appropriate to consider the nutrition via PEG. Using this method, it is possible to ensure an adequate access for enteral nutrition for a longer time without risk of complications associated with the nasoenteric tube, with minimum trouble to the patient. (Fig. 1, Ref. 9.).
Piskac
P
P
2nd Department of Surgery, Masaryk University, Brno, Czech Republic. petr.piskac@fnusa.cz
Leypold
J
J
Hnizdil
L
L
Dvorak
M
M
Piskacova
I
I
D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods; D006801:Humans