title: Unsedated transnasal PEG placement.
abstract: BACKGROUND
  By using a small-diameter endoscope, EGD can be performed transnasally in adults. A prospective study was conducted to evaluate the feasibility of transnasal PEG placement without conscious sedation.
  
  
  METHODS
  Unsedated transnasal PEG was attempted in 23 patients by using a 5.9-mm-diameter videoendoscope. The indication for PEG insertion, success or failure, reason(s) for failure, and adverse effects of the procedure were recorded. During the first month, all patients were monitored by telephone contact for complications and to verify functionality of the PEG.
  
  
  RESULTS
  Transnasal PEG insertion was successful in 21 (91%) patients. The cause for failure was the inability to transilluminate the abdominal wall. Complications included epistaxis (n=1), minor wound infection (n=1), and soiling around the stoma (n=1). Of the 21 patients in whom transnasal PEG placement was successful, all were alive, with a functional gastrostomy at the 1-month follow-up.
  
  
  CONCLUSIONS
  Unsedated transnasal PEG tube insertion is minimally invasive, is feasible in daily practice in selected patients, and rarely is associated with complications.
authors.affiliation: Department of Digestive Diseases, Hôpital Edouard Herriot, Lyon, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Dumortier
authors.forename: Marie-George
authors.initials: MG
authors.lastname: Lapalus
authors.forename: Adelino
authors.initials: A
authors.lastname: Pereira
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lagarrigue
authors.forename: Annick
authors.initials: A
authors.lastname: Chavaillon
authors.forename: Thierry
authors.initials: T
authors.lastname: Ponchon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016292:Procedural Sedation; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D016145:Endoscopy, Digestive System; D004750:Enteral Nutrition / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005774:Gastrostomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D011446:Prospective Studies; D020521:Stroke / Q000150:complications; D016896:Treatment Outcome