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2015 | 86 | 5 | 223-229
Tytuł artykułu

Gastrojejunostomy Inserted Through Peg (Peg-J) in Prevention of Aspiration Pneumonia. Clinical Nutrition Complication in Dysphagic Patients

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Percutaneous endoscopic gastrostomy (PEG) is the most commonly used method of access to the gastrointestinal tract in long‑term home enteral nutrition (HEN) in patients with neurogenic deglutition and stenosis of the upper gastrointestinal tract caused by tumour. One of the most common complications of HEN is pneumonia resulting from aspiration of saliva or food. The risk of aspiration and the potential consequent sudden death is further increased by concomitant delayed gastric emptying and gastroesophageal reflux disease. The aim of the study was to evaluate the efficacy of changing percutaneous endoscopic gastrostomy to a gastrojejunostomy inserted through the PEG (PEG-J) in the prevention of aspiration pneumonia. Materiał and methods. The study involved 158 patients receiving HEN by percutaneous endoscopic gastrostomy (PEG), aged 19 to 90 years. Indications for enteral nutrition in the study subjects included: neurogenic dysphagia - 95 patients (60%), and obstruction of the upper gastrointestinal tract due to cancer - 63 patients (40%). Results. The pulmonary and gastrointestinal complications were observed in 28 patients receiving gastric nutrition through PEG within one to nine months following the start of the feeding. In 20 patients, because of the symptoms of aspiration pneumonia with accompanying gastroesophageal reflux and delayed gastric emptying, PEG was changed to PEG-J as an alternative. There were no reports on food reflux and aspiration pneumonia in patients whose PEG has been replaced by PEG-J. Conclusions. The use of PEG-J appears to prevent the occurrence of aspiration pneumonia in patients receiving home enteral nutrition in the long‑term
Słowa kluczowe
Wydawca

Rocznik
Tom
86
Numer
5
Strony
223-229
Opis fizyczny
Daty
wydano
2014-05-01
otrzymano
2014-04-29
online
2014-07-01
Twórcy
  • Department of General Surgery and Clinical Nutrition, Warsaw Medical University, p.o Kierownika: dr n. med. M. Ławiński, do 2013 r. prof. dr hab. M. Pertkiewicz, michal-lawinski@wp.pl
  • Interdisciplinary Center for Applied Cognitive Studies – Warsaw School of Social Sciences and Humanities, Kierownik: prof. dr hab. G. Sędek
  • Department of General Surgery and Clinical Nutrition, Warsaw Medical University, p.o Kierownika: dr n. med. M. Ławiński, do 2013 r. prof. dr hab. M. Pertkiewicz
  • Department of General Surgery and Clinical Nutrition, Warsaw Medical University, p.o Kierownika: dr n. med. M. Ławiński, do 2013 r. prof. dr hab. M. Pertkiewicz
  • Department of General Surgery and Clinical Nutrition, Warsaw Medical University, p.o Kierownika: dr n. med. M. Ławiński, do 2013 r. prof. dr hab. M. Pertkiewicz
  • Department of General Surgery and Clinical Nutrition, Warsaw Medical University, p.o Kierownika: dr n. med. M. Ławiński, do 2013 r. prof. dr hab. M. Pertkiewicz
Bibliografia
  • 1. Meier R: Endoscopic access (PEG and PEJ), Basics in Clinical Nutrition. L. Sobotka (red.), Wydawnictwo Lekarskie PZWL, Warszawa 2004; 207-209.
  • 2. Suzuki Y , Tamez S, Murakami A et al.: Survival of geriatric patients after percutaneous endoscopic gastrostomy in Japan. World J Gastroenterol 2010; 16(40): 5084-91.[Crossref]
  • 3. Löser Ch, Aschl G, Hébuterne X et al.: ESPEN guidelines on artificial enteral nutrition - Percutaneous endoscopic gastrostomy (PEG). Clinical Nutriton 2005; 24: 848-61.
  • 4. Chen HL, Shih SC, Bair MJ et al.: Percutaneous Gastrostomy in the Enteral Feeding of the Elderly. Int J Gerontol 2011; 30: 1-4.[WoS]
  • 5. Krishnan B, Babu S, Walker J et al.: Gastrointestinal complications of diabetes mellitus. World J Diabetes 2013; 4(3): 51-63.[Crossref]
  • 6. Horiuchi A, Nakayama Y, Sakai R et al.: Elemental diets may reduce the risk of aspiration pneumonia in bedridden gastrostomy-fed patients. Am J Gastroenterol 2013; 108(5): 804-10.[PubMed][WoS][Crossref]
  • 7. Bankhead RR, Fisher CA, Rolandelli RH: Gastrostomy tube placement outcomes: comparison of surgical, endoscopic, and laparoscopic methods. Nutr in Clin Practice 2005; 20(6): 607-12.[Crossref]
  • 8. Lee TH, Shiun Y C: Changes in Gastroesophageal Reflux in Patients With Nasogastric Tube Followed by Percutaneous Endoscopic Gastrostomy. J Formosan Med Associat 2011; 110(2): 115-19.
  • 9. Laskaratos FM, Walker M, Walker M et al.: Predictive Factors for Early Mortality After Percutaneous Endoscopic and Radiologically-Inserted Gastrostomy. Digestive Dis and Scienc 2013 Aug 23.
  • 10. Azzopardi N, Ellul P: Pneumonia and mortality after percutaneous endoscopic gastrostomy insertion. Turkish J Gastroenterol 2013; 24(2): 109-16.[WoS]
  • 11. Simon T, Fink AS: Recent experience with percutaneous endoscopic gastrostomy/jejunostomy (PEG/J) for enteral nutrition. Surg Endosc 2000 - Springer.[PubMed]
  • 12. Kadakia SC, Sullivan HO, Starnes E: Percutaneous endoscopic gastrostomy or jejunostomy and the incidence of aspiration in 79 patients. Amer J Surg 1992; 164(2): 114-18.
  • 13. Panagiotakis PH, DiSario JA, Hilden K et al.: DPEJ tube placement prevents aspiration pneumonia in high-risk patients. Nutr in Clin Practice 2008; 23(2): 172-75.[Crossref][WoS]
  • 14. Fan AC, Baron TH, Rumalla A et al.: Comparison of direct percutaneous endoscopic jejunostomy and PEG with jejuna extension. Gastrointestinal Endoscopy 2002; 56(6): 890-94[Crossref]
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_pjs-2014-0039
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