Audit of outcome of long-term enteral nutrition by percutaneous endoscopic gastrostomy

Lancet. 1993 Apr 3;341(8849):869-72. doi: 10.1016/0140-6736(93)93072-9.


Percutaneous endoscopic gastrostomy (PEG) is the preferred method for administration of long-term enteral tube feeding. However, most published studies describe only short-term follow-up in any detail. We report the long-term outcome and complication rate after PEG insertion in 49 patients (mean [SE] age 64 [2] years) whose mean length of PEG feeding was 175 days (range 30-560). Data were collected prospectively. PEG insertion was technically successful in all cases, with a procedure-related mortality of 2%. Early (< 30 days) mortality and morbidity were 8% and 22%, respectively. Of 45 patients surviving for more than 30 days, 76% were able to return home and 6 patients were eventually able to revert to oral feeding. There were 27 late complications: 2 site infections, 17 mechanical problems, and 8 episodes of gastrointestinal dysfunction. 51% of patients had no problems at all and 22% had 2 or more complications. 47% of complications required a hospital visit for resolution. Long-term enteral feeding by PEG was safe, effective, and had a low complication rate. Our patients were managed by a specialist nutrition team, a policy that may reduce the complication rate and hospital visits for patients being fed at home, and allow early discharge of dysphagic patients, thereby reducing costs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Deglutition Disorders / therapy
  • Diarrhea / etiology
  • Endoscopy, Gastrointestinal
  • Enteral Nutrition* / adverse effects
  • Female
  • Follow-Up Studies
  • Gastrostomy* / adverse effects
  • Gastrostomy* / methods
  • Gastrostomy* / mortality
  • Home Nursing
  • Humans
  • Long-Term Care
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Patient Care Team
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Prospective Studies
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / mortality
  • Survival Rate
  • Time Factors