Abstract

COSTAGUTA, Alejandro  and  TABACCO, Omar. Gastrostomía endoscópica percutánea en pacientes con daño neurológico grave: 15 años de práctica. Arch. argent. pediatr. [online]. 2007, vol.105, n.2, pp.129-133. ISSN 0325-0075.

Introduction. The nutritional care of neurologically disabled patients is particularly challenging. In the past 20 years, percutaneous endoscopic gastrostomy has gained wide acceptance as a safe and simple method for getting access to the stomach allowing the patient to be fed when a swallowing disorder is present. Objective. To report the applicability and complications observed by our team during the first 15 years of performing percutaneous endoscopic gastrostomy. Patients. 215 consecutive patients (117 males) with severe neurological damage, aged 2 months to 21 years, and receiving nutritional support by nasogastric tube since at least 3 months before the procedure, between March 1991 and March 2006. Design: Descriptive and retrospective study on applicability, morbility and 30-day mortality related to the procedure. Results. 215 procedures were done over 217 candidates (applicability of 99%). There were 8 patients showing different complications (3.7%), all being solved by medical treatment. In 9 patients (4.1%) severe gastroesophageal reflux developed, which required surgery (5 cases) or jejunal feeding (4 cases) to subside. One patient died because of pneumonia 20 days after the procedure. Altogether, almost 92% of the patients did not show any complication that could be attributed to the gastrostomy. Conclusion. Pecutaneous endoscopic gastrostomy appeared to be a safe and simple method for nutritional care of neurologically handicapped patients that cannot be fed by oral route.

Keywords : Percutaneous gastrostomy; Nutritional support; Swallowing disorder.

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