[Pull percutaneous endoscopic gastrostomy: personal experience].
OBJECTIVE
To review the indications, complications, and outcomes of percutaneous endoscopic gastrostomy (PEG), that are placed routinely in patients unable to obtain adequate nutrition from oral feeding for swallowing disorders (neurological diseases, head and neck cancer, oesophageal cancer, psychological disorders).


METHODS
Retrospective review of patients referred for PEG placement from 2003 to 2005.


METHODS
Endoscopic Surgery in Section of General and Thoracic Surgery, Faculty of Medicine and Surgery, Palermo, Italy.


METHODS
A total of 50 patients, 11 women and 39 men, referred our Section for PEG placement. Indications for PEG placement included various neurologic impairment (82%), oesophageal non-operable cancer (6%), cardia non-operable cancer (4%), cerebrovascular accident (2%), anorexia (2%), pharyngeal esophageal obstruction (2%), head and neck cancer (2%). All patients received preoperative antibiotics as short-term profilaxis.


RESULTS
51 PEGs were positioned in 50 patients. No major complications were registered; 45 patients (90%) were alive at 1 year follow-up and no mortality procedure-related was registered. Percutaneous endoscopic gastrotomy removal had been performed on 2 patients as end-point of treatment, and 43 patients continued to have PEGs in use at 2006.


CONCLUSIONS
Outpatients PEG placement using conscious sedation is a safe and effective method for providing enteral nutrition. This technique constitutes the gold standard treatment for enteral nutrition in patients with neurologic impairment or as prophylactic in patients affected by head and neck cancer who needs demolitive surgery. Patients should be carefully assessed, and discussion with the patient and their families should be held to determine that the patient is an appropriate candidate. The Authors feel prophylactic antibiotics lessened the incidence of cutaneous perigastrostomy infection.
Geraci
G
G
Università degli Studi di Palmero, Azienda Ospedaliero Universitaria Policlinico Paolo Giaccone, Dipartmento di Chirurgia Generale, d'Urgenza e dei Trapianti d'Organo, Unità Operativa di Chirurgia Generale ad Indirizzo Toracico, Italy.
Sciumè
C
C
Pisello
F
F
Li Volsi
F
F
Facella
T
T
Tinaglia
D
D
Modica
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005773:Gastroscopy; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies