RESUMO
Objetivo. El objetivo de este trabajo ha sido revisar nuestra experiencia durante 8 años de la utilización de la gastrostomía endoscópica percutánea (GEP) y su aplicación en nutrición enteral domiciliaria (NED). Material y métodos. Estudiamos 207 pacientes (56 mujeres y 151 hombres) a los que se le ha realizado GEP desde 1994 al 2002 inclusive, al requerir nutrición enteral de forma prolongada (> 4 semanas). En aquellos casos en los que se programó NED los pacientes/familiares fueron adiestrados en las técnicas y cuidados de la GEP y de la NE, y el control se hizo a través de la consulta externa de Nutrición. Resultados. El tiempo medio de duración de la GEP fue de 640 días y 175 pacientes (84,6%) necesitaron la GEP más de 60 días, mientras que 135 la requirieron más de 6 meses. El aporte calórico medio fue de 1.730 ± 288 Kcal/día; el modo de administración fue mediante infusión intermitente por gravedad en 162 casos y por infusión continua a través de bomba volumétrica en 45 pacientes. En dos pacientes con hiperémesis gravídica se realizó gastroyeyunostomía endoscópica percutánea (GYEP) en el tercer y cuarto mes de embarazo, terminándose con éxito la gestación mediante parto por vía vaginal. La realización de la GEP facilitó el alta hospitalaria y la programación de la NED en 195 pacientes (94%). Las complicaciones más frecuentes fueron la infección de la gastrostomía, que ocurrió en 41 pacientes, y la aparición de granuloma en la ostomía en 34 casos. Sólo hubo un paciente que falleció en relación directa con una peritonitis tras la GEP. Conclusión. De nuestro trabajo se infieren las ventajas de la GEP como técnica de nutrición enteral, permitiendo la instauración de un programa de NED con escasa incidencia de complicaciones y muy baja mortalidad
Background. This study aimed to review our experience during 8 years in the use of percutaneous endoscopic gastrostomy (PEG) and its application in home enteral nutrition (HEN). Material. We studied 207 patients (56 women and 151 men) who had undergone a PEG from the beginning of 1994 to the end of 2002 as they needed prolonged enteral nutrition (> 4 weeks). In those cases in which home enteral nutrition was programmed, the patients/relatives were trained in the techniques and care of the PEG and EN, and the control was done through the nutrition out-patient clinic. Results. Mean duration time of the PEG was 640 days and 175 patients (84.6%) needed PEG for more than 60 days and 135 for more than 6 months. Mean calorie supply was 1,730 ± 288 Kcal/day. Administration mode was by intermittent infusion due to seriousness in 162 cases and continuous infusion through volemetric pump in 45 patients. In 2 patients with hyperemesis gravidarum, percutaneous endoscopic gastrojejunostomy (PEGJ) was done in the 3rd and 4th month of pregnancy, the pregnancy finishing successfully by vaginal delivery. Performance of PEG facilitated hospital discharge and programming of home enteral nutrition in 195 patients (94%). The most frequent complications were gastrostomy infection that occurred in 41 patients and the appearance of granuloma in the ostomy in 34 cases. Only one patient died in direct relationship due to peritonitis after PEG. Conclusion. Our study includes the advantages of PEG as an enteral nutrition technique, permitting the establishment of a home enteral nutrition program with limited incidence of complications and very low mortalityBackground. This study aimed to review our experience during 8 years in the use of percutaneous endoscopic gastrostomy (PEG) and its application in home enteral nutrition (HEN). Material. We studied 207 patients (56 women and 151 men) who had undergone a PEG from the beginning of 1994 to the end of 2002 as they needed prolonged enteral nutrition (> 4 weeks). In those cases in which home enteral nutrition was programmed, the patients/relatives were trained in the techniques and care of the PEG and EN, and the control was done through the nutrition out-patient clinic. Results. Mean duration time of the PEG was 640 days and 175 patients (84.6%) needed PEG for more than 60 days and 135 for more than 6 months. Mean calorie supply was 1,730 ± 288 Kcal/day. Administration mode was by intermittent infusion due to seriousness in 162 cases and continuous infusion through volemetric pump in 45 patients. In 2 patients with hyperemesis gravidarum, percutaneous endoscopic gastrojejunostomy (PEGJ) was done in the 3rd and 4th month of pregnancy, the pregnancy finishing successfully by vaginal delivery. Performance of PEG facilitated hospital discharge and programming of home enteral nutrition in 195 patients (94%). The most frequent complications were gastrostomy infection that occurred in 41 patients and the appearance of granuloma in the ostomy in 34 cases. Only one patient died in direct relationship due to peritonitis after PEG. Conclusion. Our study includes the advantages of PEG as an enteral nutrition technique, permitting the establishment of a home enteral nutrition program with limited incidence of complications and very low mortalityBackground. This study aimed to review our experience during 8 years in the use of percutaneous endoscopic gastrostomy (PEG) and its application in home enteral nutrition (HEN). Material. We studied 207 patients (56 women and 151 men) who had undergone a PEG from the beginning of 1994 to the end of 2002 as they needed prolonged enteral nutrition (> 4 weeks). In those cases in which home enteral nutrition was programmed, the patients/relatives were trained in the techniques and care of the PEG and EN, and the control was done through the nutrition out-patient clinic. Results. Mean duration time of the PEG was 640 days and 175 patients (84.6%) needed PEG for more than 60 days and 135 for more than 6 months. Mean calorie supply was 1,730 ± 288 Kcal/day. Administration mode was by intermittent infusion due to seriousness in 162 cases and continuous infusion through volemetric pump in 45 patients. In 2 patients with hyperemesis gravidarum, percutaneous endoscopic gastrojejunostomy (PEGJ) was done in the 3rd and 4th month of pregnancy, the pregnancy finishing successfully by vaginal delivery. Performance of PEG facilitated hospital discharge and programming of home enteral nutrition in 195 patients (94%). The most frequent complications were gastrostomy infection that occurred in 41 patients and the appearance of granuloma in the ostomy in 34 cases. Only one patient died in direct relationship due to peritonitis after PEG. Conclusion. Our study includes the advantages of PEG as an enteral nutrition technique, permitting the establishment of a home enteral nutrition program with limited incidence of complications and very low mortality
