The Use of Percutaneous Endoscopic Gastrostomy – Overview of Indications, Description of the Technique and Current Trends in Neurology

Czech version

Authors: B. Kianička ¹ ; J. Žák ²; M. Bareš ³
Authors‘ workplace: LF MU a FN u sv. Anny v Brně II. interní klinika ¹; LF MU a FN u sv. Anny v Brně I. chirurgická klinika ²; LF MU a FN u sv. Anny v Brně I. neurologická klinika ³
Published in: Cesk Slov Neurol N 2012; 75/108(2): 165-169
Category: Review Article

Overview

Percutaneous endoscopic gastrostomy (PEG) is a mini-invasive method, during which a gastrostomic tube is inserted through the wall of the stomach directly into the stomach using a gastroscope. Considerring the increasing use of this method in an ever expanding spectrum of patients, including neurological patients, and the gradual broadening of therapeutic indications for PEG, the aim of this work is to offer a comprehensive overview of PEG indications with emphasis on neurological diseases. The PEG technique, contraindications and possible complications are also described.

Key words:
nasojejunal tube – percutaneous endoscopic gastrostomy – PEG/jejunal tube – Parkinson’s disease

Sources

1. Gauderer MW, Ponsky JL, Izant RJ Jr. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg 1980; 15(6): 872–876.

2. Kamler J, Axmann K. Gastrostomie – současnost a budoucnost. Endoskopie 1993; 2: 49–50.

3. Kohout P, Skládaný Ľ et al. Perkutánní endoskopická gastrostomie a její místo v algoritmu umělé výživy. Praha: Galén 2002.

4. Neudert C, Oliver D, Wasner M, Borasio GD. The course of terminal phase in patients with amyotrophic lateral sclerosis. J Neurol 2001; 248(7): 612–616.

5. Norton B, Homer-Ward M, Donelly MT, Long RG, Holmes GK. A randomized prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding after acute dysphagic stroke. BMJ 1996; 312(7022): 13–16.

6. Bareš M. Pozdní hybné komplikace Parkinsonovy nemoci – wearing-off fenomén a další motorické komplikace. Neurol Prax 2008; 9(2): 96–99.

7. Kaňovský P, Kubová D, Bareš M, Hortová H, Streitová H, Znojil V. Levodopa-induced dyskinesias and continuous subcutaneous infusions of apomorphine: results of two-years, prospective follow-up. Mov Disord 2002; 17(1): 188–191.

8. Růžička E, Streitová H, Jech R, Kaňovský P, Roth J, Rektorová I et al. Amantadine infusion in treatment of motor fluctuations and dyskinesias in Parkinson’s disease. J Neural Transm 2000; 107(11): 1297–1306.

9. Sacks BA, Vine HS, Palestrant AM, Ellison HP, Shropshire D, Lowe R. A nonoperative technique for establishment of a gastrostomy in the dog. Invest Radiol 1983; 18(5): 485–497.

10. Russell TR, Brotman N, Norris F. Percutaneous gastrostomy: a new simplified and cost-effective technique. Am J Surg 1984; 148(1): 132–137.

11. Kohout P. Perkutánní endoskopická gastrostomie. Postgrad Med 2001; 3: 413–415.

12. Kohout P, Beneš Z, Antoš Z, Rozmahel M, Puškárová G, Sokol P et al. Perkutánní endoskopická gastrostomie – zkušenosti Centra pro PEG v letech 2002–2008. Prakt Lék 2008; 88(12): 710–716.

13. Vlček P, Veverková L, Čapov I, Korbička J, Chalupník Š, Jedlička V et al. Využití robotického systému da Vinci při řešení kompletního prolapsu rekta. Endoskopie 2010; 19(1): 9–13.

14. Vlček P, Čapov I, Jedlička V, Chalupník Š, Korbička J, Veverková L et al. Robotické výkony v kolorektální chirurgii. Rozhl Chir 2008; 87: 135–137.

15. Vlček P, Korbička J, Čapov I, Wechsler J, Vlčková P, Dolina J et al. Functional Results of Operative Treatment of Rectal Prolapse. 9th Biennial Congress of the European Council of Coloproctology – ECCP. Athens: Pianoro: International Proceedings Division: 361–368.

16. Vlček P, Korbička J, Čapov I, Wechsler J, Vlčková P, Dolina J et al. Pathogenesis and Management of Rectoceles Outcome Using Selective Criteria for Rectocele repair. 9th Biennial Congress of the European Council of Coloproctology – ECCP. Athens: Pianoro: International Proceedings Division: 369–375.

17. Vlček P, Korbička J, Chalupník Š, Jedlička V, Veverková L, Čapov I et al. Our experience with a 3D mesh in the management of rectal prolapse. Scripta Medica 2006; 79(2): 123–132.

18. Buchman AL, Moukarzel AA, Bhuta S, Belle M, Ament ME, Eckhert CD et al. Parenteral nutrition is associated with intestinal morphologic and functional changes in humans. JPEN J Parenter Enteral Nutr 1995; 19(6): 453–460.

19. Mallampalli A, McClave SA, Snider HL. Defining tolerance to enteral feeding in the intensive care unit. Clin Nutr 2000; 19(4): 213–215.

20. Kudsk KA, Croce MA, Fabian TC, Minard G, Tolley EA, Poret HA et al. Enteral versus parenteral feeding. Effects on septic morbidity after blunt and penetrating abdominal trauma. Ann Surg 1992; 215(5): 503–513.

21. Moore FA, Moore EE, Jones TN, McCroskey BL, Peterson VM. TEN versus TPN following major abdominal trauma: reduced septic morbidity. J Trauma 1989; 29(7): 916–923.

22. Frost P, Bihari D. The route of nutritional support in the critically ill: physiological and economical considerations. Nutrition 1997; 3 (Suppl 9): 58S–63S.

23. Heyland D, Cook DJ, Winder B, Brylowski L, Van deMark H, Guyatt G. Enteral nutrition in critically ill patients: a prospective survey. Crit Care Med 1995; 23(6): 1055–1060.

24. McClave SA, Sexton LK, Spain D, Adams JL, Owens NA, Sullins MB et al. Enteral tube feeding in the intensive care unit: factors impeding adequate delivery. Crit Care Med 1999; 27(7): 1252–1256.

25. Sitzmann JV. Nutritional support of the dysphagic patient: methods, risks, and complications of therapy. JPEN J Parenter Enteral Nutr 1990; 14(1): 60–63.

26. Klodell T, Carroll M, Carrillo EH, Spain DA. Routine intragastric feeding following traumatic brain injury is safe and well tolerated. Am J Surg 2000; 179(3): 168–171.

27. Montecalvo MA, Steger KA, Farber HW, Smith BF, Dennis RC, Fitzpatrick GF et al. Nutricional outcome and pneumonia in critical care patients randomized to gastric versus jejunal tube feedings. The Critical Care Research Team. Crit Care Med 1992; 20(10): 1377–1381.

28. Korbička J, Čapov I, Vlček P. Pneumoperitoneum bez perforace trávícího ústrojí. Rozhl Chir 2002; 81(7): 364–371.

29. Rey JR, Axon A, Budzynska A, Kruse A, Nowak A. Guidelines of the European Society of Gastrointestinal Endoscopy (ESGE). Antibiotic prophylaxis for gastrointestinal endoscopy. European Society of Gastrointestinal Endoscopy. Endoscopy 1998; 30(3): 318–324.

30. Kirby DF, Delegge MH, Fleming CR. American Gastroenterological Association. technical review on tube feeding for enteral nutrition. Gastroenterology 1995; 108(4): 1282–1301.

31. Schapiro GD, Edmundowicz SA. Complications of percutaneous endoscopic gastrostomy. Gastrointest Endosc Clin N Am 1996; 6(2): 409–422.