[Percutaneous endoscopic gastrostomy in patients with intractable neurological diseases--retrospective study of the indication, complication and prognosis].
We investigated retrospectively 157 neurological patients who underwent percutaneous endoscopic gastrostomy (PEG) since 2003 May to 2006 January, focusing on their neurological diagnosis, complication, relation to ventilatory support and survival prognosis. Among 157 patients, 42 patients had amyotrophic lateral sclerosis, 39 Parkinson's disease, and 27 multiple system atrophy. The percentage for the neurodegenerative diseases was 68.0%. The most frequent complication during PEG procedure was transient hypoxia (8 patients), three of whom needed oxygen therapy, but no patients received emergent artificial ventilation. After PEG. six patients experienced accidental self-removal of the catheter, but there was no subsequent peritonitis. Seven patients were on tracheostomy positive-pressure ventilation during PEG. and two on non-invasive intermittent positive-pressure ventilation around the PEG period, in all of whom the PEG was carried out without any trouble. Investigation on survival after PEG showed that nine ALS patients died within six months because of respiratory failure. We conclude that PEG for neurological patients was generally performed safely. For ALS patients, however, respiratory function should be carefully monitored, and PEG should be performed in ALS patients before their respiratory function becomes worse.
Shimizu
Toshio
T
Nutrition Support Team, Tokyo Metropolitan Neurological Hospital.
Hanaoka
Takuya
T
Hayashi
Hideaki
H
Inoue
Hitoshi
H
Imamura
Kazuhiro
K
Oyanagi
Kiyomitsu
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy*; D005260:Female; D005773:Gastroscopy / Q000009:adverse effects; D005774:Gastrostomy / Q000009:adverse effects; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications*; D018529:Nutritional Support / Q000379:methods*; D011175:Positive-Pressure Respiration; D011379:Prognosis; D012189:Retrospective Studies