Background: Percutaneous endoscopic gastrostomy (PEG)
tubes are widely used for nutritional support of patients with dysfunctional swallowing
of various etiologies and an otherwise intact gastrointestinal tract. The short and
longterm outcomes of enteral nutrition using this technique in Jordan are largely
unknown.
Objective: We aimed to describe the indications, the rate of successful placement,
complication rates, and long term outcome of PEG tubes placed in a variety of patients
at King Abdullah University Hospital in Northern Jordan.
Methods: Between the period from April, 2003, until March, 2007, 155 consecutive patients
with PEG tubes inserted during this period (using the Ponsky pull technique) were
identified from our database. The demographic data, primary and secondary underlying
medical conditions, and post-placement complications were analyzed. Phone calls with
caregivers were made to gather information about the short and long-term outcomes
of using PEG tubes.
Results: Complete data were available for 85/155 (55%) of the patients reviewed. PEG
tubes were successfully placed in 99% of cases, with no procedure-related complications.
The most common indication for PEG tube placement was neuromuscular dysphagia documented
in 46%, followed by decrease in level of consciousness or coma in 38% of the patients.
Post placement major complications were noted in 5% of cases in the form of sepsis,
bleeding, and stoma mucosa necrosis. Minor complications such as stoma leak, skin
irritation, and gastrointestinal upset were noted in 41% of patients. At four year
follow up, the overall mortality was 53%. Twenty-one percent of patients had their
tube replaced, 27% recovered normal swallowing function and had their tube removed,
while 20% of patients were still dependent on the tube for nutritional support.
Conclusions: PEG tube placement at our institution has an acceptable success rate.
Short and long-term outcomes are comparable to published series. Proper selection
of patients with expected survival benefit would likely minimize the mortality and
the complication rate.
Key-words:
Percutaneous endoscopic gastrostomy - Mortality rate - Complications.
