Invited Commentary

Commentary on "Feeding After Percutaneous Endoscopic Gastrostomy: Experience of Early Versus Delayed Feeding"

Authors: John W. Birk, MD, Renée M. Marchioni, Beery DO

Abstract

Percutaneous endoscopic gastrostomy (PEG) is a common procedure performed in patients with intact gastrointestinal function who are unable to meet their nutritional requirements orally for a multitude of reasons. Developed by Ponski and Gauderer in the 1980s,1 PEG insertion has supplanted surgical placement as a means of establishing an effective route for long-term enteral nutrition. Frequent indications for PEG placement include dysphagia associated with neurodisability such as stroke or dementia and neoplasms of the head, neck, and esophagus. Other clinical situations for which PEG placement is indicated include catabolic states requiring supplemental nutrition (patients in the intensive care unit) and gastric decompression in the setting of obstruction (peritoneal carcinomatosis) or severe dysmotility.

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References

1. Ponski JL, Gauderer MW. Percutaneous endoscopic gastrostomy: a nonoperative technique for feeding gastrostomy. Gastrointest Endosc 1981;27:9-11.
 
2. Laskaratos FM, Walker M, Walker M, et al. Predictive factors for early mortality after percutaneous endoscopic and radiologically-inserted gastrostomy. Dig Dis Sci 2013;58:3558-3565.
 
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5. ASGE Standards of Practice Committee, Jain R, Maple JT, et al. The role of endoscopy in enteral feeding. Gastrointest Endosc 2011;74:7-12.
 
6. Szary NM, Arif M, Matteson ML, et al. Enteral feeding within three hours after percutaneous endoscopic gastrostomy placement: a meta-analysis. J Clin Gastroenterol 2011;45:e34-e38.
 
7. Bechtold ML, Matteson ML, Choudhary A, et al. Early versus delayed feeding after placement of a percutaneous endoscopic gastrostomy: a meta-analysis. Am J Gastroenterol 2008;103:2919-2924.