Study of percutaneous endoscopic gastrostomy compared to nasogastric tube feeding in patients requiring prolong enteral nutritional support
DOI:
https://doi.org/10.18203/2349-2902.isj20202821Keywords:
NG tube feeding, PEG, Anthropometric parametersAbstract
Background: The aims and objectives of this article were to compare the advantages, disadvantages associated with percutaneous endoscopic gastrostomy (PEG) and nasogastric (NG) tube and also to compare complications, to measure the outcomes in terms of hospital stay, mortality and improvement in nutritional status.
Methods: In this prospective and interventional study 25 patients were selected in each group on an alternate basis. Study was conducted on cases of traumatic brain injury and cerebrovascular accident patients admitted in Department of General Surgery, IGGMC for a period of November 2013- November 2015 with a need to provide prolonged enteral nutritional support. Each patient was assessed by a dietician and received a standard enteral feeding according to their body weight. The main outcome was measures at 4 weeks were complications (tube dislodgement, aspiration pneumonia, tube blockade and peristomal infections) and nutritional status.
Results: The anthropometric parameters (mid arm circumference, biceps skin fold thickness and triceps skin fold thickness) and serum albumin showed a rise in PEG group at 4 weeks when compared to baseline (0 week) whereas they showed a decline in NG group at follow up (4 weeks). The NG group has got higher mortality 4 (17%) when compared to PEG group 2 (7%) due to aspiration pneumonia. Hence, PEG is better tolerated with lesser complications better nutritional support as assessed by the anthropometric parameters at 4 weeks.
Conclusions: We conclude that whenever feasible percutaneous endoscopic gastrostomy (PEG) feeding is a choice over nasogastric (NG) feeding in patients requiring long term enteral support.
References
Chao KC, Deasy JO, Markman J, Haynie J, Perez CA, Purdy JA, et al. A prospective study of salivary function sparing in patients with head-and-neck cancers receiving intensity-modulated or three-dimensional radiation therapy: initial results. Int J Radiat Oncol Biol Phys. 2001;49:907-16.
Shah FZ, Suraiya HS, Poi PH, Tan KS, Lai PS, Ramakrishnan K, et al. Long-term nasogastric tube feeding in elderly stroke patients- an assessment of nutritional adequacy and attitudes to gastrostomy feeding in Asians. J Nutr Health Aging. 2012;16(8):701-6.
Gomes Jr CA, Andriolo RB, Bennett C, Lustosa SA, Matos D, Waisberg DR, et al. Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances. Cochrane database Syst Rev. 2010;11:cd008096.
Vanek W. Ins and outs of enteral access: part 2- long term access esophagostomy and gastrostomy. Nutr Clin Pract. 2003;18:50-74.
Gauderer MWL, Ponsky JL, Izant RJ Jr. Gastrostomy without laparotomy: A percutaneous endoscopic technique. J Pediatr Surg. 1980;15:872-5.
Ponsky JL, Gauderer MW, Stellato TA. Percutaneous endoscopic gastrostomy. Review of 150 cases. Arch Surg. 1983;118:913-4.
Strodel WE, Lemmer J, Eckhauser F, Botham M, Dent T. Early experience with endoscopic percutaneous gastrostomy. Arch Surg. 1983;118:449-53.
Larson DE, Fleming CR, Ott BJ, Schroeder KW. Percutaneous endoscopic gastrostomy. Simplified access for enteral nutrition. Mayo Clin Proced. 1983;58:103-7.
Thatcher BS, Ferguson DR, Paradis K. Percutaneous endoscopic gastrostomy: a preferred method of feeding tube gastrostomy. Am J Gastroenterol. 1984;79:748-50.
Russell TR, Brotman M, Norris F. Percutaneous gastrostomy. A new simplified and cost-effective technique. Am J Surg. 1984;148:132-7.
Ponsky JL, Gauderer MW, Stellato TA, Aszodi A. Percutaneous approaches to enteral alimentation. Am J Surg. 1985;149:102-5.
Kirby DF, Craig RM, Tsang TK, Plotnick BH. Percutaneous endoscopic gastrostomies: a prospective evaluation and review of the literature. J Parenter Enteral Nutr. 1986;10:155-9.
Hamidon BB, Abdullah SA, Zawawi MF, Sukumar N, Aminuddin A, Raymond AA. A prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with acute dysphagic stroke. Med J Malaysia. 2006;61(1):59-66.
Sobani ZA, Ghaffar S, Ahmed BN. Comparison of outcomes of enteral feeding via nasogastric versus gastrostomy tubes in post-operative patients with a principle diagnosis of squamous cell carcinoma of the oral cavity. J Pak Med Assoc. 2011;61:1042-5.
Corry J, Poon W, Mc Phee N, Milner AD, Cruickshank D, Porceddu SV, et al. Prospective study of percutaneous endoscopic gastrostomy (PEG) versus nasogastric tubes for enteral feeding in head and neck cancer patients treated with (chemo) radiation. Head Neck. 2009;31(7):867-76.
Corry J, Poon W, McPhee N, Milner AD, Cruickshank D, Porceddu S, et al. Randomized study of percutaneous endoscopic gastrostomy versus nasogastric tubes for enteral feeding in head and neck cancer patients treated with (chemo) radiation. J Med Imag Radiation Oncol. 2008;52(5):503-10.
Youssef GY, Alnajjar A, Elsherbiny M. A comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in prolonged dysphagic stroke patients. Advanced Arab Acad Audio-Vestibul J. 2015;2(1):14-8.
Mekhail TM, Adelstein DJ, Rybicki LA, Larto MA, Saxton JP, Lavertu P. Enteral nutrition during the treatment of head and neck carcinoma: is a percutaneous endoscopic gastrostomy tube preferable to a nasogastric tube? Cancer. 2001;91(9):1785-90.
Magné N, Marcy PY, Foa C, Falewee MN, Schneider M, Demard F, et al. Comparison between nasogastric tube feeding and percutaneous fluoroscopic gastrostomy in advanced head and neck cancer patients. Eur Arch Oto-Rhino-Laryngol. 2001;258(2):89-92
Sadasivan A, Faizal B, Kumar M. Nasogastric and percutaneous endoscopic gastrostomy tube use in advanced head and neck cancer patients: a comparative study. J Pain Palliat Care Pharmacother. 2012;26:226-32.
Rustom IK, Jabreel A, Tayyab M, England RJA, Stafford ND, percutaneous endoscopic, radiological and surgical gastrostomy tubes: a comparison study in head and neck cancer patients. J Laryngol Otol. 2006;120:463-6.
Ehrsson YT, Langius-Eklof A, Bark T, Laurell G. percutaneous endoscopic gastrostomy (PEG)- a long term follow up study in head and neck cancer patients. Clinical Otolaryngol. 2004;29:740-6.