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• Vol.47 No.9
• CLINICA NEUROL, 47: 565−570, 2007
• Vol.47 No.9 contents

Original Article

Percutaneous endoscopic gastrostomy in patients with intractable neurological diseases -Retrospective study of the indication, complication and prognosis-

Toshio Shimizu, M.D.¹⁾²⁾, Takuya Hanaoka, M.D.²⁾, Hideaki Hayashi, M.D.¹⁾²⁾, Hitoshi Inoue, M.D.³⁾, Kazuhiro Imamura, M.D.³⁾ and Kiyomitsu Oyanagi, M.D., Ph.D.⁴⁾⁵⁾

¹⁾Nutrition Support Team, Tokyo Metropolitan Neurological Hospital
²⁾Department of Neurology, Tokyo Metropolitan Neurological Hospital
³⁾Department of Surgery, Tokyo Metropolitan Fuchu Hospital
⁴⁾Department of Pathology, Tokyo Metropolitan Neurological Hospital
⁵⁾Department of Neuropathology, Tokyo Metropolitan Institute for Neuroscience

We investigated retrospectively 157 neurological patients who underwent percutaneous endoscopic gastrostomy (PEG) since 2003 May to 2006 January, focusing on their neurological diagnosis, complication, relation to ventilatory support and survival prognosis. Among 157 patients, 42 patients had amyotrophic lateral sclerosis, 39 Parkinson's disease, and 27 multiple system atrophy. The percentage for the neurodegenerative diseases was 68.0%. The most frequent complication during PEG procedure was transient hypoxia (8 patients), three of whom needed oxygen therapy, but no patients received emergent artificial ventilation. After PEG, six patients experienced accidental self-removal of the catheter, but there was no subsequent peritonitis. Seven patients were on tracheostomy positive-pressure ventilation during PEG, and two on non-invasive intermittent positive-pressure ventilation around the PEG period, in all of whom the PEG was carried out without any trouble. Investigation on survival after PEG showed that nine ALS patients died within six months because of respiratory failure. We conclude that PEG for neurological patients was generally performed safely. For ALS patients, however, respiratory function should be carefully monitored, and PEG should be performed in ALS patients before their respiratory function becomes worse.

(CLINICA NEUROL, 47: 565−570, 2007)
key words: percutaneous endoscopic gastrostomy, complication, amyotrophic lateral sclerosis, nutritional support, positive-pressure ventilation

(Received: 12-Mar-07)