Indications, effectiveness and safety of percutaneous endoscopic gastrostomy: a single center experience and literature review

Abstract

Background and Objectives: Percutaneous endoscopic gastrostomy (PEG) has been widely used since 1980 in enteral feeding of patients that are not able to be fed orally for a long time. The aim of this study is to evaluate the PEG indications, effectiveness and PEG related complications from a single center in Istanbul, Turkey. Methods and Study Design: 265 patients with PEG who were followed up by the clinical nutrition team of a university hospital between 2010-2018 were evaluated retrospectively. Nutritional Risk Screening-2002 (NRS-2002) test, anthropometric measurements, bioelectrical impedance analysis and laboratory data were used to evaluate the patients' nutritional status. Results: The most common indications for PEG were dementia (35.1%), amyotrophic lateral sclerosis (22.6%), stroke (15.8%), and cancer (14%). The mean body weight of the patients was increased after PEG (63.5 +/- 12.2 vs 62.0 +/- 12.7 kg). Mid upper arm circumference and calf circumference of the patients increased after PEG (27.5 +/- 2.5 vs 25.4 +/- 3.1 cm and 32.2 +/- 7.9 vs 29.6 +/- 5.9 cm, respectively). Serum albumin of the patients was increased significantly after PEG (3.34 +/- 0.69 g/dL to 3.64 +/- 0.65 g/dL) without any significant change in serum CRP. Subgroup analyses showed a significant increase in the mean serum albumin of patients with dementia after PEG (3.23 +/- 0.67 g/dL to 3.54 +/- 0.58 g/dL). Local insertion site infection occurred in 15 patients (5.6%) and only 3 patients had systemic inflammatory symptoms after local infection (1.1%). Conclusions: The results of our study showed that long-term enteral feeding with PEG is an effective and safe method that provides improvement in nutritional status.