



Tradicionalmente, el inicio de nutrición enteral, luego de una gastrostomía endoscópica percutánea (GEP) se realiza entre 12 a 24 horas. Diferentes investigaciones sugieren que iniciarla más temprano podría ser una opción segura. El objetivo es determinar si el inicio de nutrición enteral a las 4 horas después de realizar GEP es una conducta segura en cuanto al riesgo de intolerancia, complicaciones o muerte, comparado con iniciarla a las 12 horas. Realizamos un estudio prospectivo, aleatorizado, multicéntrico en instituciones de tercer y cuarto nivel de Bogotá y Cundinamarca, entre junio de 2020 y mayo de 2022, se incluyeron 117 pacientes que fueron aleatorizados en 2 grupos, el grupo A de inicio temprano de nutrición (4 horas), y el grupo B de inicio estándar (12 horas). El mecanismo más frecuente de disfagia fue la enfermedad cerebrovascular (43%), seguido por complicaciones de infección por COVID-19 (26%). No hubo diferencias estadísticamente significativas entre los grupos evaluados respecto al porcentaje de intolerancia a la nutrición, RR = 0,93 (IC 0,30-2,90), tampoco hubo diferencias en términos de complicaciones posoperatorias, (RR) = 0,34 (IC 0,09-1,16), y no se encontraron diferencias en la mortalidad entre los grupos evaluados, (RR) = 1,12 (IC 0,59 – 2,15). En conclusión, el inicio de nutrición a través de la gastrostomía de forma temprana, 4 horas después de la realización de la GEP es una conducta segura que no se relaciona con una mayor intolerancia a la nutrición, complicaciones o muerte, en comparación con un inicio más tardío.





Inicio de nutrición enteral luego de una gastrostomía endoscópica, ¿es necesario esperar

Introduction: The aim of this study was to determine the indications
of Percutaneous endoscopic gastrostomy (PEG) patients treated in a
secondary state Burdur hospital over a period of three years, the unit
where the patient was hospitalized, survival time with PEG therapy,
and the complications observed in these patients.
Methods: Patients who underwent PEG in the endoscopy unit
of our hospital, between January 2019 and January 2022, were
retrospectively evaluated. Age, gender, the unit of inpatient, indications
for PEG therapy, complications after PEG, and survival status of the
patients were recorded in the form of case reports. Patients with
coagulation disorders, hemodynamic instability, peritonitis, sepsis,
infection at the insertion area, peritonitis carcinomatosis, a history of
total gastrectomy and gastric varices were excluded.
Results:The median age of the 120 patients included in the study
was 79 (17–100) years, and 66 (55%) of the patients were male.
Complications were observed in 14 (11.7%) patients, all of which
were minor, including seven (5.8%) PEG site infections, three (2.5%)
PEG site leakages, three (2.5%) PEG occlusions, and one (0.9%)
PEG removal. It was determined that 73 (60.8%) patients survived
at least 30 days; the patients were most frequently referred by the
neurology unit, with a rate of 52.7%. The most common indications for
PEG insertion were cerebrovascular disease (56.7%) and dementia
(29.2%).
Conclusion: Maintenance of nutritional requirements via PEG allows
for the preservation of mucosal integrity and barrier function, intestinal
immune response, and normal flora. It is superior to other enteral
feeding methods due to the lower risk of aspiration. In conclusion,
our study, which presented the experiences of the PEG insertion and
therapy in a secondary state hospital, stated that the complication
rates, indications, and referring clinics were found to be consistent
with available literature.

/pdf/percutaneous-endoscopic-gastrostomy-results-in-a-secondary-2vtw3dmn.pdf

Percutaneous endoscopic gastrostomy results in a secondary state hospital

9. Complications of percutaneous endoscopic gastrostomy

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9. Complications of percutaneous endoscopic gastrostomy