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Lee, Shim, Lee, Lee, Chang, Tae, Moon, Kim, Jung, and Jung: Clinical Course of Percutaneous Endoscopic Gastrostomy: A Single-center Observational Study
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The Korean Journal of Gastroenterology 2018; 71(1): 24-30.

Published online: 25 January 2018

DOI: https://doi.org/10.4166/kjg.2018.71.1.24

Clinical Course of Percutaneous Endoscopic Gastrostomy: A Single-center Observational Study

Jihyun Lee, Ki-Nam Shim, Kang Hoon Lee, Ko Eun Lee, Ji Young Chang, Chung Hyun Tae, Chang Mo Moon, Seong-Eun Kim, Hye-Kyung Jung, Sung-Ae Jung

Department of Internal Medicine and Ewha Medical Research Institute, Ewha Womans University College of Medicine, Seoul, Korea.

Correspondence to: Ki-Nam Shim, Department of Internal Medicine and Ewha Medical Research Institute, Ewha Womans University College of Medicine, 1071 Anyangchun-ro, Yangcheon-gu, Seoul 07985, Korea. Tel: +82-2-2650-5887, Fax: +82-2-2655-2076, shimkn@ewha.ac.kr

Received 17 July 2017       Revised 16 September 2017       Accepted 31 October 2017

Copyright © 2018. Korean Society of Gastroenterology

Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

Percutaneous endoscopic gastrostomy (PEG) is a widely used method for long-term tube feeding. This study aimed to investigate the clinical characteristics and outcomes of patients who utilized long-term feeding tube via PEG.

Methods

The medical records of 137 patients who underwent PEG tube insertion at Ewha Womans University Mokdong Hospital between January 2002 and December 2013 were reviewed.

Results

PEG was indicated most frequently for cerebrovascular accidents (66 patients, 48.2%), followed by head and neck cancer (20 patients, 14.6%), and Parkinson's disease (10 patients, 7.3%). The tubes were endoscopically inserted in 133 patients (97.1%); 4 patients (2.9%) underwent radiologic intervention. The tubes of 90 patients (65.7%) were exchanged at least once during the follow-up period. At the first exchange, 71 patients (78.9%) had their tubes exchanged by endoscopy, 24 patients (16.7%) by manually, and 4 patients (4.4%) by radiologic intervention. Of the 61 patients (44.5%) who had their tubes exchanged twice, 44 patients (72.1%) changed their tubes by endoscopic exchange, 13 patients (21.3%) by manually, and 4 patients (4.4%) via radiologic intervention. The mean time interval between the initial insertion and the first exchange was 9.83±6.19 months, and that between the initial insertion and the second exchange was 10.7±6.25 months. Of all the 137 patients, acute complications at initial insertion occurred in only 18 patients (13.1%), with insertion site infection (9 patients, 6.6%) being the most common acute complication.

Conclusions

PEG appears to be a safe procedure for providing long-term tube feeding. Our results may help to develop strategies for further management of subjects receiving feeding tubes via PEG.

Keywords: Enteral nutrition, Gastrostomy, Endoscopy

Figures and Tables

Fig. 1

Flow chart diagram of study subjects. A total of 137 patients were enrolled in this study. Among them, 90 patients had their PEG tubes exchanged at least once, and 61 patients had their tubes exchanges at least twice. PEG, percutaneous endoscopic gastrostomy.

kjg-71-24-g001
Table 1

Clinical Characteristics of Patients Who Underwent PEG Insertion

kjg-71-24-i001

Values are presented as n (%).

PEG, percutaneous endoscopic gastrostomy.

Table 2

Method of Initial PEG Insertion

kjg-71-24-i002

Values are presented as n (%).

PEG, percutaneous endoscopic gastrostomy.

Table 3

Acute Adverse Events Related to Initial PEG Insertion

kjg-71-24-i001

Values are presented as n (%).

PEG, percutaneous endoscopic gastrostomy.

Table 4

Delayed Adverse Events Related to PEG Insertion

kjg-71-24-i004

Values are presented as n (%).

PEG, percutaneous endoscopic gastrostomy.

Table 5

Acute and Delayed Adverse Events in Patients Aged 65 or Older and Patients under 65

kjg-71-24-i005

Values are presented as n (%).

Table 6

Microorganisms Isolated in Insertion Site Infection

kjg-71-24-i006

MRSA, Methicillin-resistant Staphylococcus aureus; MSSA, Methicillin-sensitive Staphylococcus aureus; ESBL, extended-spectrum-β-lactamase.

Notes

Financial support None.

Conflict of interest None.

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