Scott M Wilhelm1, Kimberly A Ortega, Thomas A Stellato. 1. Department of Surgery, University Hospitals/Case Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, USA. Scott.wilhelm@uhhospitals.org
Abstract
INTRODUCTION: We sought to determine if percutaneous endoscopic gastrostomy (PEG) could be safely performed in an outpatient fashion. METHODS: One hundred consecutive inpatient (IP) and outpatient (OP) PEGs were analyzed. Patient demographics, PEG indication, nutritional status, complications, and 30-day mortality were determined. Data were analyzed with Student t tests (STTs) and Fisher exact tests (FETs). All OP PEG candidates were evaluated by our dietician, and postprocedure management was discussed before PEG placement. RESULTS: Seventy-four IP and 26 OP PEGs were attempted. All OP PEGs were placed for head and neck cancers, whereas only 18 of 74 (24%) of IP PEGs were performed for that reason (P<.0001 by FET). Mean pre-PEG albumin levels in OP patients were 3.86 g/dL versus 2.79 g/dL for IP patients (P<.0001 by STT). No differences were found in complication rates (OP vs IP, P=.56 by FET). Thirty-day mortality for OP patients was 0% and 9.5% for IP patients. DISCUSSION: OP PEG placement is safe and feasible in carefully selected patients. It requires a care path-driven team approach. Copyright (c) 2010 Elsevier Inc. All rights reserved.
INTRODUCTION: We sought to determine if percutaneous endoscopic gastrostomy (PEG) could be safely performed in an outpatient fashion. METHODS: One hundred consecutive inpatient (IP) and outpatient (OP) PEGs were analyzed. Patient demographics, PEG indication, nutritional status, complications, and 30-day mortality were determined. Data were analyzed with Student t tests (STTs) and Fisher exact tests (FETs). All OPPEG candidates were evaluated by our dietician, and postprocedure management was discussed before PEG placement. RESULTS: Seventy-four IP and 26 OPPEGs were attempted. All OPPEGs were placed for head and neck cancers, whereas only 18 of 74 (24%) of IP PEGs were performed for that reason (P<.0001 by FET). Mean pre-PEG albumin levels in OPpatients were 3.86 g/dL versus 2.79 g/dL for IP patients (P<.0001 by STT). No differences were found in complication rates (OP vs IP, P=.56 by FET). Thirty-day mortality for OPpatients was 0% and 9.5% for IP patients. DISCUSSION: OPPEG placement is safe and feasible in carefully selected patients. It requires a care path-driven team approach. Copyright (c) 2010 Elsevier Inc. All rights reserved.
Authors: Sang Pyo Lee; Kang Nyeong Lee; Oh Young Lee; Hang Lak Lee; Dae Won Jun; Byung Chul Yoon; Ho Soon Choi; Seung Hyun Kim Journal: Dig Dis Sci Date: 2013-10-19 Impact factor: 3.199