Current status of percutaneous endoscopic gastrostomy (PEG) in a general hospital in Japan: a cross-sectional study.
BACKGROUND
There has been debate over the indications for percutaneous endoscopic gastrostomy (PEG) in recent years in Japan. In addition, the level of satisfaction of patients and patient's family after PEG remains unclear. The aim of this study was to investigate the current status of PEG and the level of satisfaction of patients and patients' families after PEG in Japan.


METHODS
We reviewed the existing data of all patients who underwent PEG tube insertion at Yuri Kumiai General Hospital (Akita, Japan) between February 2000 and December 2010. We examined the following points: underlying diseases requiring PEG, levels of consciousness, and performance status. We also sent a questionnaire to the patients and patient's families to ask about their satisfaction with and thoughts about PEG.


RESULTS
The data of 545 patients who underwent PEG were reviewed. There were 295 men and 250 women, with a mean age of 77.2 ± 11.4 years. PEG was indicated most frequently for cerebrovascular disorders (48.2%, 239/545). There were 515 (94.4%, 515/545) patients showing consciousness disturbance and 444 (81.5%, 444/545) bedridden patients. The questionnaire was answered by one patient himself and 316 patients' families. When asked, "Was performing PEG a good decision?", 57.5% (182/316) of the patients' families answered yes. Meanwhile, when patients' family members were asked if they would wish to undergo PEG if they were in the same condition as the patient, 28.4% (90/316) answered yes, whereas 55.3% (175/316) answered no.


CONCLUSIONS
Few patients were able to make their own decision about PEG tube placement because of consciousness disturbance. As a result, many family members of the patients did not want to experience PEG for themselves. Future studies should be performed to clarify the quality of life and ethical aspects associated with PEG.
Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan; Department of Gastroenterology, Yuri Kumiai General Hospital, Japan.
Chika
C
Kusano
Yamada Diabetes Gastroenterology Clinic, Japan.
Nobuo
N
Yamada
Department of Neurological Surgery, Yuri Kumiai General Hospital, Japan.
Kenji
K
Kikuchi
Department of Surgery, Yuri Kumiai General Hospital, Japan.
Masaji
M
Hashimoto
Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Japan.
Takuji
T
Gotoda
current status; percutaneous endoscopic gastrostomy; questionnaire survey