title: Percutaneous endoscopic gastrostomy for decompression of malignant bowel obstruction.
abstract: BACKGROUND
  Previous reports on percutaneous endoscopic gastrostomy (PEG) for bowel decompression have included a relatively small number of patients and the details of post-procedural outcomes and complications are lacking. The aim of the present study was to evaluate the outcomes and safety of PEG for bowel decompression in a relatively large number of patients with malignant bowel obstruction.
  
  
  METHODS
  Over a 10-year period, 76 patients with malignant bowel obstruction were referred to the main referral cancer center in Shizuoka prefecture for PEG to obtain decompression. The method for gastrostomy was carried out by the pull-method, the modified introducer method and the percutaneous endoscopic gastrojejunostomy method. Patient demographics, procedural success, complications, elimination of nasal intubation, and survival were reviewed.
  
  
  RESULTS
  Successful placement was achieved in 93% of patients (71/76). Procedure-related complications occurred in 21% ofpatients (15/71), of which the majority involved stomal leakage (eight patients), and wound infection (six patients). There were no procedure-related deaths. Among the 55 patients who required nasal intubation before PEG, a trans-gastrostomy intestinal tube was inserted in 16 patients. The need for further nasal intubation was eliminated in 96% of the patients (53/55). The median survival time was 63 days (range, 8-444 days) after PEG placement.
  
  
  CONCLUSIONS
  PEG for bowel decompression in patients with malignant obstruction can be carried out with an acceptable risk of minor complications. In combination with a trans-gastrostomy intestinal tube insertion, the elimination of nasal intubation can be achieved in most patients.
authors.affiliation: Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Kawata
authors.forename: Naomi
authors.initials: N
authors.lastname: Kakushima
authors.forename: Masaki
authors.initials: M
authors.lastname: Tanaka
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sawai
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Imai
authors.forename: Tomoko
authors.initials: T
authors.lastname: Hagiwara
authors.forename: Toshitatsu
authors.initials: T
authors.lastname: Takao
authors.forename: Kinichi
authors.initials: K
authors.lastname: Hotta
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Kohei
authors.initials: K
authors.lastname: Takizawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsubayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ono
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: gastrointestinal decompression; malignant obstruction; percutaneous endoscopic gastrojejunostomy (PEG-J); percutaneous endoscopic gastrostomy (PEG); percutaneous trans-esophageal gastro-tubing (PTEG)