Abstract
Background and Study Aims: Percutaneous endoscopic gastrostomy (PEG) is a simple method of achieving non-surgical
gastric decompression in patients suffering from metastatic abdominal tumors and upper
gastrointestinal tract obstruction. The aim of this prospective study was both to
evaluate the efficacy of PEG for intestinal decompression in patients with disseminated
abdominal cancer and to compare two catheters with different diameters.
Patients and Methods: Over a one-year period, 22 consecutive female patients (mean age 53.7, range 29-73)
were referred to us and a PEG was successfully placed in 21. In four patients with
unsatisfactory endoscopic transillumination of the anterior abdominal wall, an ultrasound
unit was used to identify an adequate site for PEG placement.
Results: All patients experienced substantial symptomatic relief after a few days: vomiting
and nausea completely resolved, and abdominal pain persisted in one patient only.
No gastrostomy-related additional morbidity was noticed. We randomly inserted a 15-French
or a 20-French tube: no statistically significant difference was noticed between the
two in the symptomatic relief provided.
Conclusions: Our data support the hypothesis that PEG is an effective, safe, and well-tolerated
method of achieving gastric decompression in cancer patients; ultrasound guidance
was an interesting option in positioning a tube in difficult situations; a standard
nutritional tube, namely 15 or 20 French in diameter, may be large enough to obtain
excellent clinical results.
