Definition of percutaneous endoscopic gastrostomy
Percutaneous endoscopic gastrostomy – PEG is a modern interventional endoscopic technique used to provide long-term nutrition for patients who have lost the ability to swallow. This technique is common, helps patients undergo surgery, is safe and has few complications that can arise.
During PEG, a gastric tube is inserted through the abdominal wall into the patient’s stomach, without performing open surgery. Food will then be pureed and pumped into the tube.
This method is employed for patients who are unable to feed themselves but need to be provided with enough nutrition for the body. If the patient does not ensure adequate nutrition, the treatment of their underlying disease will be less effective. They will not have enough energy for treatment, and injuries can take a longer time to heal.
Some diseases requiring the use of PEG include: digestive disorders such as tumors, esophageal cancer stroke patients, patients with anorexia, and severe malnutrition.
Advantages of percutaneous endoscopic gastrostomy
Percutaneous endoscopic gastrostomy offers numerous benefits, making it an ideal choice for long-term enteral feeding.
Enhanced nutrition delivery
In providing patients with gastrointestinal symptoms the adequate amount of nutrition through PEG, family and caregivers can be more proactive in selecting the food that is pumped through the tube and into the body. Medical intervention through PEG can ensure a nutritious diet is absorbed.
Minimally invasive procedure
One of the advantages of this method is that it is minimally invasive. The PEG procedure requires only a small incision and the use of an endoscope. This reduces complications, reduces pain, and has a faster recovery time than traditional surgical methods. Implementation time is also fast, taking only 15 – 30 minutes.
Cost-effective solution
Due to providing enough nutrients, patients are able to recover faster, helping to improve the treatment process more effectively. This reduces the need for extended hospital stays and frequent medical interventions, leading to overall cost savings. Furthermore, the cost of percutaneous endoscopic gastrostomy is not as high as more invasive surgical solutions.
Customizable nutrition plans
With PEG, healthcare providers can tailor nutrition plans to meet the specific needs of the patient. This customization ensures that patients receive the appropriate nutrients, vitamins, and minerals required for their condition.
Reduced risk of aspiration pneumonia
Patients with swallowing difficulties are at risk of aspiration pneumonia, a condition where food or liquid enters the lungs. PEG significantly reduces this risk by bypassing the oral route and delivering nutrition directly to the stomach.
Improved quality of life
For patients with chronic conditions or those recovering from surgery, PEG can significantly improve the quality of life. It reduces the need for frequent hospital visits for nutritional support and allows patients to receive care in the comfort of their homes.
Notes when performing percutaneous endoscopic gastrostomy
Performing percutaneous endoscopic gastrostomy requires careful planning and execution to ensure patient safety and optimal outcomes.
Pre-Procedure Preparation
Before surgery, patients need to do tests and measure indicators to evaluate their health status.
- Medical evaluation: A thorough medical evaluation is necessary to determine the patient’s suitability for PEG. This includes reviewing the patient’s medical history, current medications, and any underlying conditions.
- Informed consent: Obtain informed consent from the patient or their legal guardian, explaining the procedure, potential risks, and benefits.
- Fasting: Patients are usually required to fast for 6-8 hours before the procedure to ensure an empty stomach.
- Medication adjustments: Certain medications may need to be adjusted or discontinued before the procedure. Consult with your healthcare provider for specific instructions.
Procedure Steps
Notes during percutaneous endoscopic gastrostomy are strictly followed by specialists.
- Anesthesia: Local anesthesia is administered to numb the area, and sedatives may be given to help the patient relax.
- Endoscope insertion: An endoscope is inserted through the mouth and into the stomach to visualize the stomach’s interior.
- Site selection: The optimal site for the feeding tube is identified and marked on the abdomen.
- Incision and tube placement: A small incision is made in the abdomen, and the feeding tube is inserted into the stomach through the incision.
- Securing the tube: The tube is secured in place with a retention device to prevent dislodgement.
- Verification: The correct placement of the tube is verified using imaging techniques.
Post-Procedure Care
Post-operative care is extremely important. This determines the patient’s ability to recover.
- Monitoring: Patients are monitored for any immediate complications, such as bleeding or infection.
- Tube care: Proper care and maintenance of the feeding tube are essential to prevent infections and blockages. This includes regular cleaning and checking for signs of infection.
- Nutrition management: A dietitian will provide guidelines on the type and amount of nutrition to be administered through the tube.
- Follow-Up appointments: Schedule regular follow-up appointments with the healthcare provider to monitor the patient’s condition and make necessary adjustments.
Potential Complications and Management
Below are some complications that relatives or patients need to know to prevent:
- Infection: Signs of infection include redness, swelling, and discharge around the tube site. Prompt medical attention is required to manage infections.
- Tube dislodgement: If the tube becomes dislodged, immediate medical attention is necessary to reinsert it properly.
- Blockages: Regular flushing of the tube with water can help prevent blockages. If a blockage occurs, consult with the healthcare provider for proper management.
- Gastrointestinal issues: Some patients may experience nausea, vomiting, or diarrhea. Adjusting the feeding regimen can help manage these symptoms.
By understanding the advantages and necessary considerations of percutaneous endoscopic gastrostomy, you can make an informed decision and ensure optimal care for yourself or a loved one.
