Experiences, early and late complications of percutaneous endoscopic gastrostomy during medium-term follow up

Percutaneous endoscopic gastrostomy (PEG) is one of the most useful tools for enteral nutrition. It has been shown that the nutritional status and the overall survival, occasionally the quality of life can be improved with placement of PEG catheter to ensure adequate nutritional support. PEG catheter can be inserted in patients in various neurological diseases in which the adequate nutritional status cannot be achieved because of functional causes and also anatomical lesions i.e. head and neck cancers. Aim: The retrospective evaluation of the quality of life, the rate of occurrence of early and late complications associated with PEG catheter placement.

Patients And Methods: Between 2000 January and 2004 December, PEG catheter insertions were performed in 22 patients. The underlying reasons of PEG catheter placement were the followings: ischaemic or hemorrhagic stroke in 12 patients, epipharyngeal cancer in 2 patients, oesophageal cancer in 3 patients, end-stage sclerosis multiplex and anorexia nervosa in one patient. The mean age at PEG placement was 69 years, the male/female ratio was 1/16. Data were collected retrospectively by reviewing the charts of patients. Long term follow-up data were obtained by mail or phone from the relatives of the patients. Data processing was based on a well-established QOL questionnaire specifically developed for patients underwent PEG catheter placement. Results: Early complications were not detected after PEG catheter placement. Late complications included dislocation of the catheter in 1 patient and insertion sit phelgmon in another patient. Eight patients died during the index admission period, at a mean of 10 days after PEG catheter placement because of the rapid progression of the underlying disease. Seven patients died within 3 months after in-hospital treatment. One patient with sclerosis multiplex is still alive with functioning PEG catheter. One patient with anorexia nervosa was capable to return to normal eating behaviour and the PEG catheter was removed. Three patients were lost for follow-up.

Conclusions: According to our result on PEG catheter insertion and the feeding through the catheter, PEG seems to be a safe method and associated with only very few complications. PEG catheter insertion should be considered as early as possible in selected patient population to achieve better long term results.