A Multicenter Survey of Percutaneous Endoscopic Gastrostomy in 2019 at Korean Medical Institutions
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Background/Aims: This study aimed to review the indications, methods, cooperation, complications, and outcomes of percutaneous endoscopic gastrostomy (PEG). Methods: Questionnaires were sent to 200 hospitals, of which 62 returned their questionnaires, with a response rate of approximately 30%. Descriptive statistics were calculated to analyze the responses to the questionnaires. Results: In 2019, a total of 1,052 PEGs were performed in 1,017 patients at 62 hospitals. The main group who underwent PEG was older adult patients with brain disease, particularly stroke. Nutritional supply was an important purpose of the PEG procedure. “The pull method” was the most commonly used for initial PEG insertion. The complications related to PEG were mostly mild, with leakage being the most common. Patients who underwent PEG procedures were primarily educated regarding the post-procedure management and complications related to PEG. Preoperative meetings were skipped at >50% of the institutions. Regarding the cooperation between the nutrition support team (NST) and the physician performing PEG, few endoscopists answered that they cooperated with NST before and after PEG. Moreover, the rate of NST certification obtained by physicians performing PEG and the frequency of attendance at NST-related conferences were relatively low. Conclusions: This study shows a similar trend to that found in the previous PEG guidelines. However, it covers new aspects, including team-based work for PEG procedure, nutrition support, and education for patients and guardians. Therefore, each medical institution needs to select an appropriate method considering the medical environment and doctor’s abilities.
Abstract
Background/Aims: This study aimed to review the indications, methods, cooperation, complications, and outcomes of percutaneous endoscopic gastrostomy (PEG). Methods: Questionnaires were sent to 200 hospitals, of which 62 returned their questionnaires, with a response rate of approximately 30%. Descriptive statistics were calculated to analyze the responses to the questionnaires. Results: In 2019, a total of 1,052 PEGs were performed in 1,017 patients at 62 hospitals. The main group who underwent PEG was older adult patients with brain disease, particularly stroke. Nutritional supply was an important purpose of the PEG procedure. “The pull method” was the most commonly used for initial PEG insertion. The complications related to PEG were mostly mild, with leakage being the most common. Patients who underwent PEG procedures were primarily educated regarding the post-procedure management and complications related to PEG. Preoperative meetings were skipped at >50% of the institutions. Regarding the cooperation between the nutrition support team (NST) and the physician performing PEG, few endoscopists answered that they cooperated with NST before and after PEG. Moreover, the rate of NST certification obtained by physicians performing PEG and the frequency of attendance at NST-related conferences were relatively low. Conclusions: This study shows a similar trend to that found in the previous PEG guidelines. However, it covers new aspects, including team-based work for PEG procedure, nutrition support, and education for patients and guardians. Therefore, each medical institution needs to select an appropriate method considering the medical environment and doctor’s abilities.
참고문헌 (31)
- Felekis D, "Effect of perioperative immuno-enhanced enteral nutrition on inflammatory response, nutritional status, and outcomes in head and neck cancer patients undergoing major surgery", Nutr Cancer, 62, pp.1105~1112 (2010)
- Sharma K, "Pathophysiology of critical illness and role of nutrition", Nutr Clin Pract, 34, pp.12~22 (2019)
- Tae CH, "Clinical practice guidelines for percutaneous endoscopic gastrostomy", Clin Endosc, 56, pp.391~408 (2023)
- Dietrich CG, "Percutaneous endoscopic gastrostomy : too often? Too late? Who are the right patients for gastrostomy?", World J Gastroenterol, 26, pp.2464~2471 (2020)
- Mogensen KM, "Nutritional status and mortality in the critically ill", Crit Care Med, 43, pp.2605~2615 (2015)
- Braunschweig CL, "Enteral compared with parenteral nutrition : a meta-analysis", Am J Clin Nutr, 74, pp.534~542 (2001)
- Gramlich L, "Does enteral nutrition compared to parenteral nutrition result in better outcomes in critically ill adult patients? A systematic review of the literature", Nutrition, 20, pp.843~848 (2004)
- Rahnemai-Azar AA, "Percutaneous endoscopic gastrostomy : indications, technique, complications and management", World J Gastroenterol, 20, pp.7739~7751 (2014)
- Gkolfakis P, "Endoscopic management of enteral tubes in adult patients. Part 2 : periand post-procedural management. European Society of Gastrointestinal Endoscopy(ESGE)Guideline", Endoscopy, 53, pp.178~195 (2021)
- Pih GY, "Clinical outcomes of percutaneous endoscopic gastrostomy in the surgical intensive care unit", Clin Endosc, 53, pp.705~716 (2020)
- Kim Y, "Simulator-based training method in gastrointestinal endoscopy training and currently available simulators", Clin Endosc, 56, pp.1~13 (2023)
- Arvanitakis M, "Endoscopic management of enteral tubes in adult patients. Part 1 : definitions and indications. European Society of Gastrointestinal Endoscopy(ESGE)Guideline", Endoscopy, 53, pp.81~92 (2021)
- Jung SO, "Nutritional impact of percutaneous endoscopic gastrostomy : a retrospective single-center study", Korean J Gastroenterol, 79, pp.12~21 (2022)
- Park JH, "Clinical review of percutaneous endoscopic gastrostomy(PEG)in children", Korean J Gastrointest Endosc, 31, pp.291~296 (2005)
- Suzuki Y, "A survey of percutaneous endoscopic gastrostomy in 202 Japanese medical institutions", Japan Med Assoc J, 49, pp.94~105 (2006)
- Veitch AM, "Endoscopy in patients on antiplatelet or anticoagulant therapy, including direct oral anticoagulants : British Society of Gastroenterology(BSG)and European Society of Gastrointestinal Endoscopy(ESGE)guidelines", Endoscopy, 48, pp.385~402 (2016)
- Itkin M, "Multidisciplinary practical guidelines for gastrointestinal access for enteral nutrition and decompression from the Society of Interventional Radiology and American Gastroenterological Association(AGA)Institute, with endorsement by Canadian Interventional Radiological Association(CIRA)and Cardiovascular and Interventional Radiological Society of Europe(CIRSE)", Gastroenterology, 141, pp.742~765 (2011)
- Baltz JG, "Mortality after percutaneous endoscopic gastrostomy in patients with cirrhosis : a case series", Gastrointest Endosc, 72, pp.1072~1075 (2010)
- Panigrahi H, "Role of antibiotic prophylaxis for wound infection in percutaneous endoscopic gastrostomy(PEG) : result of a prospective double-blind randomized trial", J Hosp Infect, 50, pp.312~315 (2002)
- Boeykens K, "Prevention and management of major complications in percutaneous endoscopic gastrostomy", BMJ Open Gastroenterol, 8, pp.e000628~ (2021)
- Wei M, "An overview of percutaneous endoscopic gastrostomy tube placement in the intensive care unit", J Thorac Dis, 13, pp.5277~5296 (2021)
- Kim YM, "Massive gastric bleeding occuring after the replacement of percutaneous endoscopic gastrostomy tube", Korean J Gastrointest Endosc, 28, pp.247~250 (2004)
- ASGE Technology Committee, "Enteral nutrition access devices", Gastrointest Endosc, 72, pp.236~248 (2010)
- Bechtold ML, "Early versus delayed feeding after placement of a percutaneous endoscopic gastrostomy : a meta-analysis", Am J Gastroenterol, 103, pp.2919~2924 (2008)
- Szary NM, "Enteral feeding within three hours after percutaneous endoscopic gastrostomy placement : a meta-analysis", J Clin Gastroenterol, 45, pp.e34~e38 (2011)
- Vyawahare MA, "A comparative observational study of early versus delayed feeding after percutaneous endoscopic gastrostomy", Indian J Gastroenterol, 32, pp.366~368 (2013)
- Attam R, "Endoscopic sutured gastropexy : a novel technique for performing a secure gastrostomy(with videos)", Gastrointest Endosc, 79, pp.1011~1014 (2014)
- Wei MT, "Over-the-scope clip in the treatment of gastrointestinal leaks and perforations", Clin Endosc, 54, pp.798~804 (2021)
- Roveron G, "Clinical practice guidelines for the nursing management of percutaneous endoscopic gastrostomy and jejunostomy(PEG", PEJ)in adult patients : an executive summary, 2018, pp.45, 326~334
- Burney RE, "Safety and long-term outcomes of percutaneous endoscopic gastrostomy in patients with head and neck cancer", Surg Endosc, 29, pp.3685~3689 (2015)
- Pironi L, "ESPEN guideline on home parenteral nutrition", Clin Nutr, 39, pp.1645~1666 (2020)