Is Percutaneous Endoscopic Gastrostomy Tube Feeding Beneficial for Improving Survival in Patients With Dementia? A Systematic Review and Meta-Analysis of Current Pieces of Evidence

2022 ◽  
Author(s):  
Shima Raeesi ◽  
Rezvan Hashemi ◽  
Zahra Vahabi ◽  
Mina Abdolahi ◽  
Mohsen Sedighiyan
Keyword(s):  
Systematic Review ◽  
Mortality Rate ◽  
Median Survival ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Tube Feeding ◽  
Nutritional Deficiencies ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Endoscopic Gastrostomy

Dementia is a progressive, disabling neurogenic disease that results in serious nutritional deficiencies included dysphagia, malnutrition, and weight loss. The Percutaneous Endoscopic Gastrostomy (PEG) is a long-term enteral feeding method that is routinely used in demented patients with poor food intake as a standard protocol. However, most of the pieces of evidence have not shown the beneficial effects of PEG feeding on complications or survival rates in these patients. Some studies have even reported an increase in mortality. The current systematic review and meta-analysis aimed to evaluate the mortality rate and survival in primary demented patients with PEG. A systematic search was conducted on Pubmed and Scopus databases up to Aug 2019. The data were reviewed according to the Cochrane handbook and preferred reporting items for systematic reviews and meta-analyses (PRISMA) and meta-analysis of observational studies in epidemiology (MOOSE). Based on the random-effects model, the mortality rate and median survival were expressed as risk ratio and weighted mean difference (WMD) and 95% CI, respectively. Among 13 included studies, PEG insertion in patients with primary dementia has no significant effect on 30-day, 90-day, 180-day, 1-year, and 2- year mortality rate or median survival (WMD: 9.77; 95% CI: -22.43 to 41.98; P=0.55). It seems that nasogastric tube (NGT) feeding in compared to PEG in this population is more effective. In conclusion, further prospective studies are needed for comprehensive evaluation of mortality or survival regarding comorbidities, underlying disease, cognitive and physical performance, and nutritional problems in demented patients.

scholarly journals Is Percutaneous Endoscopic Gastrostomy (PEG) tube feeding Beneficial for Improving Survival in Patients with Dementia? A systematic review and meta- analysis of current evidences

2019 ◽  
Author(s):  
Shima Raeesi ◽  
Rezvan Hashemi ◽  
Zahra Vahabi ◽  
Mina Abdolahi ◽  
Mohsen Sedighiyan
Keyword(s):  
Systematic Review ◽  
Mortality Rate ◽  
Median Survival ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Tube Feeding ◽  
Nutritional Deficiencies ◽  
Feeding Method ◽  
Endoscopic Gastrostomy

Abstract Background Dementia is a progressive disabling neurogenic disease resulted in serious nutritional deficiencies included dysphagia, malnutrition and weight loss. The Percutaneous Endoscopic Gastrostomy (PEG) which is a long-term enteral feeding method that routinely use in demented patients with poor food intake as a standard protocol. However, most of the evidences have not shown beneficial effects of PEG feeding on complications or survival rates in these patients. Some studies have even reported an increase in mortality. The current systematic review and meta-analysis aimed to evaluate the mortality rate and survival in primary demented patients with PEG.Methods A systemically search conducted on Pubmed and Scopus databases up to Aug 2019 without language restriction. The data were reviewed according to Cochrane handbook and preferred reporting items for systematic reviews and meta-analyses (PRISMA) and meta-analysis of observational studies in epidemiology (MOOSE). Based on random-effects model, mortality rate and median survival were expressed as risk ratio and weighted mean difference (WMD) and 95% CI respectively.Results Among 13 included studies, PEG insertion in patients with primary dementia has no significant effect on 30-day, 90-day, 180-day, 1-year and 2- year mortality rate or median survival (WMD: 9.77; 95% CI: -22.43 to 41.98; P= 0.55). It seems that naso-gastric tube (NGT) feeding in compared to PEG in this population is more effective.Conclusion Further prospective studies are needed to comprehensive evaluation of mortality or survival regarding to comorbidities, underlying disease, cognitive and physical performance and nutritional problems in demented patients.

scholarly journals Endoscopic Repair of Gastrocolic and Colocutaneous Fistulas Complicating Percutaneous Endoscopic Gastrostomy Tube

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Chukwunonso Chime ◽  
Ahmed Baiomi ◽  
Kishore Kumar ◽  
Harish Patel ◽  
Anil Dev ◽  
...  
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Tube Feeding ◽  
Care Facility ◽  
Index Patient ◽  
Safe Procedure ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Term Care ◽  
Long Term Care Facility ◽  
Endoscopic Gastrostomy ◽  
Peg Tube

Percutaneous endoscopic gastrostomy (PEG) tube feeding has become one of the options for supplemental feeding in a selected group of patients. It is a generally safe procedure usually undertaken by a gastroenterologist or a surgeon in most cases but with over 200,000 tubes being placed yearly, there is bound to be complications. Some of the encountered complications include bleeding, site infection, tube migration, and inadvertent creation of fistula. We present our index patient admitted from a long-term care facility for feculent vomiting and fecal material through the PEG tube. Imaging and colonoscopy confirmed the presence of both a gastrocolic and a colocutaneous fistula, both closed endoscopically with an over-the-scope and through-the-scope clips, respectively. Feeding through a nasogastric tube was resumed after 48 hours, and by the second week of admission, the patient was discharged back to the facility after placement of a new PEG tube.

scholarly journals Systematic review of ventricular peritoneal shunt and percutaneous endoscopic gastrostomy: a safe combination

2017 ◽  
Vol 127 (4) ◽  
pp. 899-904 ◽  
Author(s):  
Leendert H. Oterdoom ◽  
D. L. Marinus Oterdoom ◽  
Johannes C. F. Ket ◽  
J. Marc C. van Dijk ◽  
Pieter Scholten
Keyword(s):  
Systematic Review ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Meta Analysis ◽  
Poor Quality ◽  
Tube Placement ◽  
Review Of The Literature ◽  
Endoscopic Gastrostomy ◽  
Peg Tube ◽  
Meta Analyses ◽  
Ventriculo Peritoneal Shunt

OBJECTIVEVarious international and national gastrointestinal guidelines take different positions on whether ventriculoperitoneal shunt (VPS) insertion is a contraindication to percutaneous endoscopic gastrostomy (PEG). The objective of this meta-analysis was to try to answer the question of whether VPS insertion is a contraindication to PEG.METHODSA systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Electronic databases PubMed and Embase were searched using variations of the terms “ventriculo-peritoneal shunt” and “percutaneous (endoscopic) gastrostomy.” This search resulted in 70 studies, 9 of which were relevant. These were cross-referenced, and 1 additional study was found, resulting in 10 studies in this systematic review.RESULTSThe 10 relevant studies in adult cohorts included 208 patients. All studies save one were retrospective and, in general, poor quality. Among the studies with relevant data, there were 26 (12.5% of 208 cases) VPS infections and 4 (4.4% of 90 cases) VPSs that malfunctioned. In 137 patients the VPS had been placed before the PEG tube, with a VPS infection rate of 4.4%. More VPS infections occurred among the 55 patients who first had a PEG and a subsequent VPS (21.8%) and in the 16 patients who had simultaneous PEG tube and VPS placement (50%). The heterogeneity of the studies in this analysis prohibited statistical comparisons of the timing of VPS and PEG tube placement.CONCLUSIONSThis systematic review indicated that VPS placement in combination with a PEG has a high but acceptable VPS complication rate. Therefore, VPS insertion should not be considered a contraindication to the placement of a PEG tube. Preferably, a PEG tube should be placed after the VPS. Waiting 7–10 days between VPS insertion and a PEG seems reasonable, but this could not be corroborated in this review.

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