title: Semi-solid feeds may reduce the risk of aspiration pneumonia and shorten postoperative length of stay after percutaneous endoscopic gastrostomy (PEG).
abstract: Background and study aims:Feeding-related adverse events after percutaneous endoscopic gastrostomy (PEG) such as aspiration pneumonia may result in prolonged hospitalization and postoperative mortality. This study evaluated the efficacy of using semi-solid feeds to reduce feeding-related adverse events and improve clinical outcomes.Patients and methods:Patients who received PEG for enteral nutrition at our hospital between January 2014 and December 2015 were allocated to a postoperative feeding protocol that used either liquid feed or semi-solid feed. Baseline characteristics, postoperative feeding-related adverse events and clinical outcomes in the 2 groups were prospectively analysed and compared.Results:One hundred and seventeen PEG patients (age range: 59 - 97 years, male: 53) were enrolled with 72 patients given liquid feed and 45 patients receiving semi-solid feed. Baseline characteristics were similar in both groups. The semi-solid feed group experienced fewer incidence of feeding-related aspiration pneumonia (2.2 % vs. 22.2 %,P< 0.005) and shorter postoperative hospital length of stay (12.7 days vs. 18.8 days,P< 0.01). Significant differences were not observed in the frequency of peristomal infection (11.1 % vs. 12.5 %,P= 0.82), feeding-related diarrhea (2.2 % vs. 12.5 %,P= 0.09) and 30-day mortality rates (2.2 % vs. 8.3 %,P= 0.25).Conclusions:Semi-solid feeding may reduce the risk of aspiration pneumonia and shorten postoperative hospital length of stay after PEG. Semi-solid feeds are safe to use and can be employed either as a first line feeding protocol or an alternative when liquid feeding is unsuccessful.
authors.affiliation: Department of Internal Medicine (Gastroenterology), Hiroshima Kyoritsu Hospital, Hiroshima City, Japan.
authors.forename: Ezekiel Wong
authors.initials: EW
authors.lastname: Toh Yoon
authors.affiliation: Endoscopy Center, Hiroshima Kyoritsu Hospital, Hiroshima City, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Yoneda
authors.affiliation: Department of Internal Medicine (Gastroenterology), Hiroshima Kyoritsu Hospital, Hiroshima City, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Nishihara