Endoscopic gastrostomy as a method of enteral nutrition providing

The aim of the study - evaluation of the effectiveness and possibility of using endoscopic gastrostomy to ensure long enteral nutrition. Materials and methods. For the period from 2004 to 2023, 125 patients aged 16 to 89 years (average 65.23 years) underwent endoscopic percutaneous gastrostomy in the clinic (68 men, 57 women). The majority of patients (105-84%) were patients with brain pathology, impaired consciousness and swallowing. Absolute indications for the intervention were impaired swallowing function, severe patient condition requiring long-term enteral nutrition including for chemotherapy or radiation therapy (10-16% of patients), preoperative preparation (2 patients with stage IV esophageal achalasia for up to 8 months and 2 patients with Zenker’s diverticulum for 2 months). Results. Endoscopic gastrostomy was inserted in all patients. No complications were observed. Preliminary dilatation of the lumen of the esophagus and (or) pharynx by bougienage along the guidewire to No. 36-40 Fr was performed in 10 (8%) patients with tumor stenosis. In the early postoperative period 6 (4,8%) patients had complications: postoperative wound suppuration in 4, abdominal phlegmon in 2, in periods longer than 14 days in 9 (7.2%): bumper syndrome in 7, gastrostomy tube prolapse in 2 patients. Conclusions. Endoscopic gastrostomy is an effective and relatively safe method of providing enteral nutrition due to its low trauma. Indications for the intervention may be diseases and traumatic brain injuries with swallowing disorders, neurological disorders (apallic syndrome), head and neck tumors for the purpose of special treatment. This technique can be used for preoperative preparation in patients with neuromuscular diseases of the esophagus. Gastrostomy tube can be removed at the end of the treatment course and/or resumption of swallowing. It is necessary to follow the rules for gastrostomy care after the patient is discharged from the hospital to prevent complications associated with long-term presence of the gastrostomy.

enteral nutrition, endoscopic gastrostomy, percutaneous gastrostomy, pull-method, endoscopy

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