Vnitr Lek 2002, 48(7):626-628

[Puncture gastrostomy in oncologic patients].

P Kohout, J Manák, Z Vacek, D Tucek: II. interní klinika Fakultní nemocnice Hradec Králové.

Puncture gastrostomies--percutaneous endoscopic gastrostomy and radiologically assisted gastrostomy--are minimally invasive methods to ensure an approach for the administration of enteral nutrition. These methods replaced the insertion of tubes during surgery (surgical gastrostomy). Percutaneous endoscopic gastrostomy (PEG) is inserted by means of a gastroscope, usually by the pull method, radiologically assisted gastrostomy (RAG) is implemented after insufflation of the stomach by a thin tube directly across the abdominal wall by the push method. In oncological patients it is preferable to administer enteral nutrition via puncture gastrostomy in case of obstruction of the upper portion of the digestive tract (oral cavity, larynx, pharynx, oesophagus), in deglutition disorders caused by cerebral tumours or in order to improve the nutritional status of patients with tumour cachexia. In the authors group in 1995-2000 a total of 53 puncture gastrostomies were made in 53 patients, 37 men and 16 women, mean age 62 years (32-94 years, incl. 38 PEG and 15 RAG. In 30 patients the reason was obstruction of the upper digestive tract, in 11 patients impaired swallowing associated with a cerebral tumour and in 12 patients the cause was tumourous cachexia. Puncture gastrostomies are well tolerated by the attending staff and patients, in oncology they can be used for administration of enteral nutrition under hospital and domiciary conditions.