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- 저자 : ( Heekyong Na ) (검색결과 1 건)
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Single-Center 11 Years Experience of Percutaneous Endoscopic Gastrostomy with 410 Patients
( Gyu Young Pih ),( Heekyong Na ),( Kee Wook Jung ),( Do Hoon Kim ),( Jeong Hoon Lee ),( Ji Yong Ahn ),( Kee Don Choi ),( Ho June Song ),( Gin Hyug Lee ),( Hwoon-yong Jung ) 한국정맥경장영양학회 2017 한국정맥경장영양학회 학술대회집 Vol.2017 No.-
Backgroud and aim: Percutaneous endoscopic gastrostomy (PEG) is the most common enteral nutritional method for patients who are difficult in oral feeding and have normal gastrointestinal function. Although PEG is an uncomplicated and minimal invasive procedure, minor and major complications have been constantly reported. The aim of this study is by reviewing single center PEG cases to analyze major and minor complications and 30-day mortality after PEG. Patients and Methods: 410 Patients who received PEG insertion at the Asan medical center between January 2005 and December 2015 were eligible. The medical records were retrospectively reviewed and clinical characteristics were investigated. Results: The median age was 68.5 years (IQR 57-77) and median BMI was 19.6 kg/m2 (IQR 17.2-21.7). The median follow up period was 355 days (IQR 80-792). The indications of PEG insertion were stroke (22.0%), parkinsonism (14.9%), neuromuscular disease (12.9%), head and neck cancer (12%), dementia (6.1%), esophageal cancer (5.1%), hypoxic brain damage (4.1%) and other indications (22.9%). One hundred forty-three patients (34.9%) underwent PEG insertion with the pull technique while two hundreds sixty-three patients (64.1%) with the introducer technique. Incidence of acute and chronic complications except chronic tube obstruction showed no significant difference between the pull type and the introducer type. Thirty-five patients (8.5%) had developed major complications and ninety-seven patients (23.7%) had showed minor complications. The 30-day mortality rates were 4.9%. In multivariate analysis, comorbidity of chronic kidney disease (Odds ratio 7.08, 95% CI: 1.86-26.92 and p value=0.004), low platelet (Odds ratio 1.007, 95% CI: 1.013- 1.002 and p value=0.013) and high CRP level (Odds ratio 1.15, 95% CI: 1.06-1.26 and p value=0.002) were significant risk factors of 30-day mortality. Conclusion: With relatively long term data, PEG is a safe and feasible procedure. However, comorbidity of chronic kidney disease, low platelet count, and elevated CRP level can be predictors of 30-day mortality.
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