Percutaneous endoscopic gastrostomy (PEG) in cancer patients; technique, indications and complications

Enteral feeding is the preferred method of nutritional support in malnourished patients with inadequate oral intake but with intact gastrointestinal tract. In cancer patients, adequate nutrition plays an important role in the success of the treatment and hence the overall prognosis. Percutaneous endoscopic gastrostomy proved to be an effective means for providing enteral nutrition with easy technique, less hospital stay and cost with less morbidity and mortality.

It is a prospective study on 40 cancer patients with different indications for PEG which is done by pull technique under local anesthesia and sedation over a period of 12 months with a follow up period of 60 days.

The procedure was successful in 38 patients (95%), 22 patients (55%) with esophageal cancer, 16 cases (40%) with head and neck cancer, and 2 cases (5%) for gastric decompression due to prepyloric gastric cancer. Mortality rate was 2.5% (1 case) due to leakage and peritonitis, and morbidity occurred in 6 cases (15%) due to port infection and minor leakage managed by dressing and systemic antibiotics.

PEG is an easy procedure for providing enteral nutrition for cancer patients and associated with fewer rates of morbidity and mortality compared to gastrostomy procedures.