title: Percutaneous endoscopic gastrostomy (PEG): retrospective analysis of a 7-year clinical experience.
abstract: OBJECTIVE
  Since its description in 1980, percutaneous endoscopic gastrostomy has become the modality of choice for providing enteral access to patients who require long-term enteral nutrition. This study aimed to evaluate current indications and complications associated with PEG feeding.
  
  
  METHODS
  We conducted a retrospective analysis of all patients who referred to our endoscopic unit of the Department of Gastroenterology and Hepatology of the Medical Center University of Sarajevo for PEG tube placement over a period of 7 years. Medical records of 359 patients dealing with PEG tube placement were reviewed to assess indications, technical success, complications and the need for repeat procedures.
  
  
  RESULTS
  The indications for enteral feeding tube placement were malignancy in 44% (n=158), of which 61% (n=97) patients were suffering of head and neck cancer and 39% (n=61) of other malignancy. Central nervous disease was the indication in 48.7 % (n=175) of patients. Cerebrovascular accidents (CVA) accounted for 20% (n=73), head injury for 16% (n=59) and cerebral palsy for 11% (n=38). In 6.13% (n=22) of patients minor complications occur which included wound infection (0.8%), inadvertent PEG removal (2.5%) and tube blockage (1.1%). 11 patients experienced major complications including hemorrhage, tube migration and perforation. There were no deaths related to PEG procedure placement and the overall 30-day mortality rate due to primary disease was 15.8%. Oral feeding was resumed in 23% of the patients and the tube was removed subsequently after 6 -12 months.
  
  
  CONCLUSIONS
  Percutaneous endoscopic gastrostomy is a save and minimally invasive endoscopic procedure associated with a low morbidity (9.2%) rate, easy to follow-up and to replace when blockage occurs. Over a seven-year period we noticed an increase of 63% in PEG placement at our department.
authors: Department of Gastroenterology and Hepatology, Clinical center of University of Sarajevo, Bosnia and Herzegovina.
authors: Nenad
authors: N
authors: Vanis
authors: Aida
authors: A
authors: Saray
authors: Srdjan
authors: S
authors: Gornjakovic
authors: Rusmir
authors: R
authors: Mesihovic
keywords: PEG; enteral nutrition; tube feeding.
references: Best Pract Res Clin Gastroenterol. 2006;20(3):605-30
references: 16782532
references: Z Gastroenterol. 2000 Mar;38(3):229-34
references: 10768245
references: Am J Gastroenterol. 2001 Sep;96(9):2556-63
references: 11569675
references: Dig Liver Dis. 2002 Dec;34(12):857-61
references: 12643294
references: Laryngoscope. 2001 Oct;111(10):1847-52
references: 11801956
references: Clin Nutr. 2005 Oct;24(5):848-61
references: 16261664
references: Hepatogastroenterology. 2002 Jul-Aug;49(46):1183-4
references: 12143232
references: Gastrointest Endosc. 1995 Oct;42(4):330-5
references: 8536902
references: Hepatogastroenterology. 2003 May-Jun;50(51):886-8
references: 12828111
references: Gastroenterol Clin North Am. 2006 Mar;35(1):83-100
references: 16530112
references: Gastrointest Endosc. 2003 Nov;58(5):739-51
references: 14595312
references: Ann Surg. 1988 May;207(5):598-603
references: 3377569
references: Gastrointest Endosc. 2003 May;57(6):747-51
references: 12709714
references: Aliment Pharmacol Ther. 2007 Mar 15;25(6):647-56
references: 17311597
references: J Pediatr Surg. 1980 Dec;15(6):872-5
references: 6780678
references: Aliment Pharmacol Ther. 2004 Oct 15;20(8):875-82
references: 15479359
references: Am J Gastroenterol. 2000 Jun;95(6):1472-5
references: 10894581
references: J Nutr Health Aging. 2000;4(1):47-50
references: 10840477
references: Gastrointest Endosc. 1995 May;41(5):508-11
references: 7615233
references: Nutr Clin Pract. 2007 Feb;22(1):68-73
references: 17242458
references: Support Care Cancer. 1993 Sep;1(5):272-5
references: 8156240