Related Experiment Videos
Is repeat endoscopy necessary after percutaneous endoscopic gastrostomy?
Olajide O Odelowo1, Lakshmi Dasaree, Yolanda Hamilton
1Division of Gastroenterology, Department of Medicine, Howard University Hospital, 2041 Georgia Avenue, NW, Washington, D.C. 20060, USA.
Journal of the Association for Academic Minority Physicians : the Official Publication of the Association for Academic Minority Physicians
|October 5, 2002
Summary
Repeat endoscopy is often unnecessary after percutaneous endoscopic gastrostomy (PEG) tube placement. In 93% of cases, initial bumper placement was adequate, suggesting repeat endoscopy should be based on endoscopist discretion for optimal PEG tube positioning.
Area of Science:
- Gastroenterology
- Minimally Invasive Procedures
- Endoscopic Surgery
Background:
- Percutaneous endoscopic gastrostomy (PEG) is a safe and effective alternative to open gastrostomy for enteral feeding.
- Two primary PEG techniques exist: Ponsky-Gauderer (pull-string) and Sachs-Vine (push-over-wire).
- Routine repeat endoscopy is often performed post-PEG to confirm optimal tube and bumper placement.
Purpose of the Study:
- To evaluate the necessity of repeat endoscopy for confirming optimal percutaneous endoscopic gastrostomy (PEG) tube bumper positioning.
- To determine the frequency of bumper adjustments during repeat endoscopy after PEG placement.
Main Methods:
- Retrospective chart review of 132 adult patients undergoing PEG between July 1994 and September 1996.
- Assessment of whether endoscopists adjusted the PEG tube bumper position during repeat endoscopy.
- Categorization of adjustments as minor (< or = 1.0 cm) or major (> 1.0 cm).
Main Results:
- PEG was successful in 125 of 132 patients.
- Of 110 patients who had repeat endoscopy, 102 (93%) required no bumper adjustment.
- Minor adjustments were made in 4% and major adjustments in 3% of patients.
Conclusions:
- Repeat endoscopy is not routinely required to confirm optimal percutaneous endoscopic gastrostomy (PEG) tube bumper positioning.
- Initial bumper placement is adequate in the vast majority of cases (93%).
- Repeat endoscopy should be reserved for cases where the endoscopist suspects improper bumper positioning.