Percutaneous endoscopic stomas for enteral feeding and drainage

The use of safe and cost-effective endoscopic techniques for the placement of tubes in the gastrointestinal tract has led to increased utilization of long-term enteral feeding in patients with impaired GI function, including many cancer patients. Of an estimated 148,000 US patients who received long-term enteral feeding outside hospitals in 1992, 43% were cancer patients. The technique of percutaneous endoscopic gastrostomy is used primarily for enteral feeding, but can also be used to place wide tubes for drainage of an obstructed GI tract. Aspiration problems can be eliminated by endoscopic placement of a feeding tube directly into the jejunum (percutaneous endoscopic jejunostomy). Patients with advanced cancer who are not surgical candidates may benefit from an external GI bypass placed endoscopically, which allows drainage through a gastrostomy and feeding through a jejunostomy distal to the obstruction.