La gastronómía endoscópica percutánea en pacientes con trastornos deglutorios de origen neurológico. Resultados de un estudio prospectivo multicéntrico internacional / Percutaneous endoscopic gastrostomy in patients with neurological diseases. Results of a prospective multicenter and international study
Acta gastroenterol. latinoam
;
34(3): 127-132, 2004. tab
Article
in Spanish
| LILACS
| ID: lil-420474
RESUMO
AIM: To determine prospectively the long-term evolution of patients with neurological diseases after insertion of percutaneous endoscopic gastrostomy (PEG). METHODS: 109 PEG were performed in 99 consecutive patients (49 females, 50 males), mean age 75 years (range: 20-97 years) as an alternative to a nasogastric tube. Patients were enterally fed because of chronic neurological swallowing difficulties: cerebrovascular disease 38, dementia 27, disordered swallowing mechanisms in elderly patients 10, motor neurona disease and multiple sclerosis 10, neuro-surgical disease 6, Parkinson's disease 3, brain tumor 3, neo-natal encephalopathy 1, HIV encephalopathy 1. The procedure took place in a dedicated endoscopy room. In all cases, prophylatic antibiotics were given and the PEG tube was inserted by the "pull" technique. RESULTS: PEG insertion was technically succesful in all cases. After PEG insertion, all patients were subsequently discharged to local nursing home facilities. 85/99 patients were long-term followed-up on an outpatient basis, 25% of them were followed for more than a year. The mean follow-up time was 3 months (range: 1-24 months). The most frequent complication were minor: local wound infection 6, ostomy leakage 8, silicon degradation 16, leading to the removal of the PEG and the placement of a new PEG tubes in 10 cases. Two major complications were observed : one gastric perforation and death 2 months after the PEG placement and one gastrocolic fistula. No aspiration pneumonia was reported. In one patient, PEG was removed after recuperation of a normal swallowing. All patients had a nutritional improvement. A total of 11 deaths occurred during the follow-up, related to the neurological disorder in 10/11 cases. Nursing home team, patient's physicians and patient's families found PEG manipulations easier than naso-gastric tube. CONCLUSION: Our study suggests that PEG is a method of choice for enteral feeding of patients with chronic neurological disorders. PEG is well-tolerated, leading to an improvement in nutritional status and offering good facilities for home nursing.
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Index:
LILACS (Americas)
Main subject:
Gastrostomy
/
Deglutition Disorders
/
Gastroscopy
/
Nervous System Diseases
Type of study:
Controlled clinical trial
/
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
Spanish
Journal:
Acta gastroenterol. latinoam
Journal subject:
Gastroenterology
Year:
2004
Type:
Article
Affiliation country:
Argentina
/
France
Institution/Affiliation country:
Hospital Juan A. Fernandez del GCBA/AR
/
Universitaire de Rouen/FR
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