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Inicio Medicina Clínica (English Edition) Percutaneous endoscopic gastrostomy. Indications, care and complications
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Vol. 152. Issue 6.
Pages 229-236 (March 2019)
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Vol. 152. Issue 6.
Pages 229-236 (March 2019)
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DOI: 10.1016/j.medcle.2019.01.012
Percutaneous endoscopic gastrostomy. Indications, care and complications
Gastrostomía endoscópica percutánea. Indicaciones, cuidados y complicaciones
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Carmen Molina Villalba
Corresponding author
carmeluximv6@gmail.com

Corresponding author.
, Juan Antonio Vázquez Rodríguez, Francisco Gallardo Sánchez
UGC Aparato Digestivo, Hospital de Poniente, El Ejido, Almería, Spain
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Tables (4)
Table 1. Main indications for the placement of a percutaneous endoscopic gastrostomy tube.
Table 2. Contraindications for the placement of a percutaneous endoscopic gastrostomy tube.
Table 3. Differential characteristics of the two most frequently used techniques.
Table 4. Complications of percutaneous endoscopic gastrostomy.
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Abstract

Percutaneous endoscopic gastrostomy (PEG) is an effective and safe method for nutritional support in patients with malnutrition and impossibility of oral intake with an estimated survival higher than the months that require enteral nutrition beyond four weeks. The main indications include neoplasms of the upper air-digestive tract and neurological diseases, with dementia currently considered a controversial indication. Anatomical alterations and infectious diseases are the most frequent contraindications. There are different endoscopic techniques; the most widely used being the “pull” method, with a low mortality. Complications are more frequent in patients with multiple pathologies and the elderly. Wound infection, extraction of the tube, tube blockage and bronchoaspiratory pneumonia are the most prevalent complications. Adequate prior preparation of the patient and exhaustive maintenance of the tube can reduce the appearance of these.

Keywords:
Percutaneous endoscopic gastrostomy
Enteral nutrition
Dementia
Abbreviations:
AGS
ESPEN
MARSA
EN
PEG
NGI
CT
ICU
Resumen

La gastrostomía endoscópica percutánea resulta un método eficaz y seguro para el soporte nutricional en pacientes con desnutrición e imposibilidad para la ingesta oral, con una supervivencia estimada superior a 2 meses que requieran nutrición enteral más allá de 4 semanas. Las principales indicaciones incluyen las neoplasias de tracto aéreo-digestivo superior y las enfermedades neurológicas, considerándose actualmente la demencia una indicación discutida. Las alteraciones anatómicas y los procesos infecciosos suponen las contraindicaciones más frecuentes. Existen distintas técnicas endoscópicas, siendo el método por tracción el más utilizado, teniendo en común todas ellas una baja mortalidad. Las complicaciones ocurren con mayor frecuencia en pacientes pluripatológicos y de edad avanzada, siendo las más prevalentes la infección de la herida, la extracción y obstrucción de la sonda y la neumonía broncoaspirativa. Una adecuada preparación previa del paciente y un exhaustivo cuidado y mantenimiento de la sonda pueden reducir la aparición de estas.

Palabras clave:
Gastrostomía endoscópica percutánea
Nutrición enteral
Demencia

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