AIM: The authors evaluate their experience with percutaneous endoscopic gastrostomy in children at the age of three months to 14 years. COHORT: Forty three patients treated with this method in the years 1995-2002. METHODS: The percutaneous endoscopic gastrostomy is applied in children under general anesthesia. In two patients only it proved to be necessary to convert to open or laparoscopic gastrostomy. RESULTS: Only minor complications were encountered. CONCLUSIONS: It became obvious that percutaneous endoscopic gastrostomy is a suitable method to provide long-term enteral nutrition in children of child age who may not be nourished sufficiently by natural ways.

• MeSH
• dítě MeSH
• enterální výživa * MeSH
• gastrointestinální endoskopie * MeSH
• gastrostomie škodlivé účinky   metody   MeSH
• kojenec MeSH
• kontraindikace MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The authors have described the indications, contraindications of percutaneous endoscopic gastrostomy (PEG) and its consecutive nutritional possibilities. They have described their own experience with 11 patients. Most common indications for the placement of a gastrostomy tube were neurological, and only in one case, esophageal diverticle. The average duration of PEG was 102 days (2-732). Besides PEG, not only polymeric diet, such as Nutrison standard sol, Fresubin, Salvimulsin, was administered, but also home-made diet, for example, mixed soup, mashed potatoes, yoghurt, juice and cocoa. The diet prepared at home was tolerated well, except for subjective data about meteorism given by one female-patient. PEG complications were minimal, in one case a dry fistula was detected after the extraction of PEG; it was closed spontaneously a week later. Another female-patient showed leukocytosis and hyperpyrexia, the etiology of which could not be proved. The patient was treated symptomatically, and three days later, leukocytosis and hyperpyrexia were normalized. A patient who has had the gastrostomy tube placed for two years, showed secretion which was treated symptomatically; now the patient is without any complications. In the last patient, there was detected an inflammation around the fixation base. Although she was treated with H2 blockers, the condition has not been improved. The authors have recommended this method in correct indications as a considerate alternative application of enteral nutrition.

• MeSH
• dospělí MeSH
• endoskopie MeSH
• enterální výživa * MeSH
• gastrostomie metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• punkce MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) is a minimally invasive routine procedure used to provide long-term enteral nutrition in selected patients with impaired oral intake. The knowledge of clinical, technical and safety features of PEG is an important issue in clinical practice.The aim of this study was to evaluate the popu-lation of patients selected for PEG insertion, describe certain aspects of the insertion procedure, assess the service life of PEG, as well as account for the number of complications and patient mortality in the six-month period following the procedure. METHODS: We used a retrospective analysis of data from medical database. The data were collected in a single endoscopic tertiary-referral center for a period of seven and a half years. RESULTS: We evaluated 326 PEG insertions performed on 292 patients with a median age of 63 years (IQR 55-70). Mortality in the six-month period following PEG insertion was 26 %. Prevailing indications for PEG insertion were oncological (53 %) and neurological (40 %) diseases, with certain fluctuation of these numbers during the observed period according to changing demands of the two medical specialties. Local anesthesia alone was applied in 56 % of patients, 38 % underwent analgosedation and 6 % required general anesthesia. Median duration of the procedure (from insertion of endoscope to its final extraction) in 68 consecutive procedures was 6 minutes (IQR 5-8). Median interval between PEG introduction and its first replacement in 21 patients was 22 months (IQR 14-31, range 4-76). 61 patients underwent PEG extraction during the observed period, 66 % of whom had oncological disease. Periprocedural complications were seen in 5.8 % of patients, of these one patient (0.3 %) suffered a serious complication. The buried bumper syndrome was observed in four patients (1.2 %), all of whom had neurological disease. CONCLUSIONS: PEG is a relatively safe procedure and can be performed in a short time using local anesthesia or analgosedation in a majority of patients. The population of patients indicated for PEG insertion reflects primarily the current needs of neurological and oncological departments. Most patients within the observed group benefit from PEG insertion for more than six months. KEY WORDS: analgosedation - complications - mortality - percutaneous endoscopic gastrostomy.

• MeSH
• enterální výživa škodlivé účinky   metody   MeSH
• gastroskopie škodlivé účinky   metody   MeSH
• gastrostomie škodlivé účinky   metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory komplikace   MeSH
• nemoci nervového systému komplikace   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• výběr pacientů MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

Percutaneous endoscopic gastrostomy (PEG) is an efficient endoscopic method that ensures enteral nutrition for a longer period of time in patients who cannot take food per os. This method is also indicated in patients suffering from disorders of the central or peripheral nervous system which developed suddenly, such as a stroke or craniocerebral injuries, or gradually, such as amyotrophic lateral sclerosis (ALS), dementia, and multiple sclerosis. It has become common practice in the cooperation between neurologists and a gastroenterologists to use PEG in patients hospitalized in a neurological ward with encephalomalacy and haemorrhage, or craniocerebral injuries (after the patient recovers from the acute stage of the disease and is transferred to a neurological ICU), as well as in patients with ALS in a progressive stage. We gradually extend the indications of PEG for other patients with neurological disorders such as patients suffering from dementia, progressive multiple sclerosis, Parkinson's disease, and progressive polyneuropathy. Of 62 patients hospitalized in a neurological ward during a period of 4.5 years, 56 patients suffered from sudden disorders of the nervous system (strokes and craniocerebral injuries) and 6 patients had gradually progressing neurological diseases (ALS, multiple sclerosis, Parkinson's disease, dementia, and polyneuropathy).

• MeSH
• dospělí MeSH
• endoskopie * MeSH
• enterální výživa * MeSH
• gastrostomie * metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• nemoci nervového systému * MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

The authors present their initial experience with percutaneous endoscopic gastrostomy and draw attention to its advantages and risks. As a basis they use their own group of patients, most of them in a very poor condition where it proved possible to ensure by this method enteral nutrition on a long-term basis.

• MeSH
• endoskopie metody   MeSH
• endoskopy MeSH
• gastrostomie přístrojové vybavení   metody   MeSH
• lidé MeSH
• punkce MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

Dysphagia is frequently encountered in patients with acute affections of the nervous system (cerebrovascular attacks, craniocerebral injuries) and in chronic nervous diseases (amyotrophic lateral sclerosis, Parkinson s disease, dementia). To these patients enteral nutrition must be administered. If the perspective of dysphagia is short (several days) then nutrition by a nasogastric tube is fully indicated and sufficient. In cases of more prolonged dysphagia and in patients with a long perspective of dysphagia percutaneous endoscopic gastrostomy (PEG) is indicated. Both these methods of enteral nutrition have their advantages and disadvantages which are manifested in different ways in patients with disorders of the nervous system. The authors compared 62 patients hospitalized in the course of 4.5 years at the neurological department who had PEG with 72 patients who had nasogastric tubes and were hospitalized at the neurological intensive care unit in the course of one year. The authors evaluated the different indications for application, the incidence of complications and the advantages and disadvantages of the two methods.

• MeSH
• endoskopie MeSH
• enterální výživa metody   MeSH
• gastrointestinální intubace * MeSH
• gastrostomie * MeSH
• lidé MeSH
• nemoci nervového systému komplikace   MeSH
• poruchy polykání etiologie   terapie   MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• srovnávací studie MeSH