Percutaneous Endoscopic Gastrostomy for Severe Neurogenic Dysphagia-the Rsuth Experience: A Case Series
Victor Wagozie *
Rivers State University and Rivers State Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
Iragonima Gideon
Department of Surgery, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: For patients whose oral intake is inadequate to meet nutritional needs, percutaneous endoscopic gastrostomy enables enteral nutritional support. In comparison with parenteral nutrition, the enteral route offers advantages that include preservation of gastrointestinal digestive function, efficient nutrient utilisation, and greater convenience for the patient.
Aims/Objectives: The study aimed to identify and establish the usefulness of PEG tube feeding, document outcomes among the treated patients, and describe our experience.
Methodology: This prospective case series included four patients with severe neurogenic dysphagia following brain tumour and stroke. All patients underwent pre-procedure assessment and evaluation for PEG tube insertion. The procedure was performed under mild sedation and local infiltration using the pull technique, after which the patients were monitored in the ward and feeding was commenced 12 hours after insertion.
Results: Four patients were included in the analysis; their mean age was 52.5 years, and the male-to-female ratio was 2:2. Brain tumours accounted for most cases of dysphagia requiring PEG feeding, whereas one patient had severe dysphagia following a cerebrovascular accident (stroke). PEG provided a convenient enteral feeding route for these patients, with subsequent improvement in clinical outcomes. After their relatives had been instructed in tube care and feeding methods, the patients were discharged home for ongoing care.
Conclusion: PEG is an effective and widely utilised method for long-term enteral nutrition in patients who cannot swallow. It is a safe and convenient feeding route for patients and reduces morbidities associated with the prolonged use of nasogastric tubes.
Keywords: PEG tube, dysphagia, brain tumours, stroke, enteral nutrition