Chuah, Kee Huat and Yim, Carolyn Chue Wai and Abdul Aziz, Nur Adilah and Loh, Ee Chin and Capelle, David Paul and Shahrizaila, Nortina and Leow, Alex Hwong Ruey (2022) Percutaneous endoscopic gastrostomy using the introducer method with ultra-slim endoscopy in amyotrophic lateral sclerosis patients with respiratory compromise: A safe technique. Journal of Gastroenterology and Hepatology, 37 (7, SI). pp. 1367-1372. ISSN 0815-9319, DOI https://doi.org/10.1111/jgh.15870.
Full text not available from this repository.Abstract
Background and Aim Percutaneous endoscopic gastrostomy (PEG) placement is recommended in patients with amyotrophic lateral sclerosis (ALS), but the procedure is considered high risk. In this study, we aimed to compare the outcome of ALS patients with and without PEG. The success of the procedure and complications of PEG insertion were also explored. Methods Patients with ALS who met the criteria for enteral feeding support were consecutively recruited. Patients who consented had PEG insertion using the modified technique of introducer method with transoral ultra-slim endoscopy. Results A total of 64 patients were recruited, of which 36 (56%) patients consented to PEG. The median age of all patients was 65 years and 59% were male. There was no difference in demographic and clinical characteristics between patients who agreed to a PEG and those who did not. The mortality rate at 6 and 12 months was lower in the PEG cohort compared with non-PEG, but this was not statistically significant (6 months: 28.6% vs 32.2%, P = 0.561; 12 months: 38.9% vs 50.0%, P = 0.374). Amongst the PEG cohort, 61% were stratified high risk and 31% moderate risk. Thirty-one percent of them required long-term home noninvasive ventilation. All patients (100%) underwent successful PEG insertion at single attempt using the modified approach. The complications reported over a period of 6 months were infected PEG site (17%), dislodged gastrostomy tube (14%), and minor bleeding (8%). Conclusion In ALS patients with moderate to high risk of PEG insertion, the introducer technique utilizing ultra-slim endoscopy guidance was well tolerated and safe.
| Item Type: | Article |
|---|---|
| Funders: | None |
| Uncontrolled Keywords: | Adverse events; Enteral feeding tube; Gastroscopy; Motor neuron disease; Nasal endoscopy; Slim endoscopy; Survival |
| Subjects: | R Medicine > R Medicine (General) R Medicine > RC Internal medicine |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 20 Oct 2023 02:44 |
| Last Modified: | 20 Oct 2023 02:44 |
| URI: | http://eprints.um.edu.my/id/eprint/42005 |
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