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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
[Radiological versus endoscopic gastrostomy in patients with amyotrophic lateral sclerosis]
María José Vallejo Herrera1, Verónica Vallejo Herrera2, Arturo Del Toro Ortega3
1Servicios de Endocrinología y Medicina Interna. Hospital Regional Universitario de Málaga.
Amyotrophic lateral sclerosis (ALS) patients need nutritional support via gastrostomy. Percutaneous radiological gastrostomy (PRG) may be safer than percutaneous endoscopic gastrostomy (PEG) for ALS patients with respiratory issues.
Area of Science:
- Neurology
- Gastroenterology
- Nutritional Science
Background:
- Amyotrophic lateral sclerosis (ALS) necessitates nutritional support, often via gastrostomy (PEG or PRG).
- Early intervention is crucial, yet diagnosis-to-placement delays persist.
Purpose of the Study:
- Analyze characteristics of ALS patients undergoing gastrostomy.
- Compare the efficacy and safety of PRG versus PEG in ALS patients.
Main Methods:
- Retrospective descriptive study of ALS patients requiring gastrostomy (2021-2023).
- Analysis of demographic and nutritional parameters for 10 patients (4 PEG, 6 PRG).
Main Results:
- Gastrostomy success rates were similar for PEG and PRG, with no complications.
- ALS patients experienced respiratory function decline despite nutritional support.
- A 30% mortality rate was observed within 12 months post-gastrostomy.
Conclusions:
- Gastrostomy is recommended upon risk of aspiration pneumonia or weight loss.
- PRG may offer a safer alternative to PEG for ALS patients with respiratory failure.
- Timely gastrostomy placement is critical, despite current diagnostic delays.
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