[Percutaneous endoscopic gastrostomy (PEG) for long-term nutrition--comparison of 2 different caliber tubes]

Percutaneous endoscopic gastrostomy (PEG) is often used nowadays for long-term enteral nutrition in patients with swallowing disorders and severely altered esophageal-duodenal transit. The most common indications for gastrostomy tubes were neurological disturbances and malignancies of the oropharynx and esophagus. We compared in a prospective sequential trial PEG-tubes of two different sizes (2.9 mm [CH-9] vs. 4.8 mm [CH-15]) with respect to placement, complications, durability and handling. The tube was successfully placed in 51 of 52 patients (98%). In 1 patient placement was impossible due to missing diaphanoscopy. The mean observation period was 22 weeks for the CH-9-tubes (n = 28) and 14 weeks for the CH-15-tubes (n = 23). The only early complication was 1 case with a hemorrhage at the site of implantation (CH-15). In both groups 2 cases of local infection were noted. In the CH-9-group 2 PEG-tubes disappeared into the stomach and in 1 case a cicatricial granuloma developed. In the CH-15-group a leak occurred 10 days after implantation. All complications were treated conservatively. There was no causal relationship between the size of tube and the complications. The period of implantation was mostly limited by the death due to the underlying disease of the patient and was not related to the type of PEG-tube. We conclude the both PEG-tubes were easy to place, safe and effective means of providing enteral nutrition. We would, however, recommend CH-15-tubes for long-term nutrition, since in our experience they were less frequently obstructed and handling for the nurses was easier.