Percutaneous endoscopic gastrostomy for feeding. A comparison between neurologic and neoplastic indications

The most common indications for percutaneous endoscopic gastrostomy (PEG) are neurologic deficits precluding adequate oral nutrition. The aim of this study was to ascertain whether PEG is as feasible, safe and effective in patients with advanced oropharyngeal, oesophageal and pulmonary carcinoma as it is in patients with neurologic deficit. PEG, attempted in 108 consecutive patients, was successful in 100 (overall success rate of 92%). On the basis of primary disease, the patients were subdivided into two groups: patients with neurologic diseases (group A, n = 50) and patients with oropharyngeal, oesophageal and lung carcinoma precluding adequate oral nutrition (group B, n = 50). No statistically significant difference was found between the PEG placement success rates of the two groups. Of the patients PEG placement 1 died and 2 had major complications. 15 out of 50 patients in group A and 11 out of 50 in group B had minor complications. No statistically significant differences were found between the mortality and morbidity rates of the two groups. Duration of nutrition was similar in both groups. In particular, 46% group A patients and 46% group B patients were PEG-fed for more than 3 months. A wider use of PEG is suggested in patients with advanced oropharyngeal, oesophageal and pulmonary carcinoma precluding adequate oral nutrition.