[Radiological versus endoscopic gastrostomy in patients with amyotrophic lateral sclerosis].

IF 2.5 4区医学 Q3 BUSINESS

Nutricion hospitalaria Pub Date : 2024-09-23 DOI:10.20960/nh.05190

María José Vallejo Herrera, Verónica Vallejo Herrera, Arturo Del Toro Ortega, María José Tapia Guerrero

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引用次数: 0

Abstract

IIntroduction: patients with amyotrophic lateral sclerosis (ALS) require nutritional support, in most cases with enteral nutrition through gastrostomy, either endoscopic (PEG) or radiological (PRG).

Objectives: to analyze the characteristics of patients with ALS at the time of PEG/PRG placement, and to compare the efficacy and safety of PRG versus PEG.

Methods: a retrospective descriptive study. All patients with ALS who required gastrostomy in the last 3 years (2021-2023) in our hospital were recruited (4 PEG and 6 PRG). Demographic and nutritional parameters were analyzed.

Results: ten patients were included, with an average age of 57 years. All patients presented with dysphagia and received oral or tube supplements prior to gastrostomy placement. The average duration of enteral nutrition was approximately 50 months, with a mortality rate of 30 % at 12 months after gastrostomy. The success rate of PEG and PRG was similar, with no complications. All patients developed deterioration of respiratory function, even after nutritional support.

Conclusion: gastrostomy should be indicated as soon as a patient is at risk of aspiration pneumonia or when weight loss begins. Although the nutritional benefit of gastrostomy is well established, there is currently a delay between diagnosis and placement of approximately 4 years. PRG appears to be safer than PEG in patients with ALS and respiratory failure.

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[肌萎缩性脊髓侧索硬化症患者的放射学胃造口术与内窥镜胃造口术]。

导言：肌萎缩性脊髓侧索硬化症（ALS）患者需要营养支持，大多数情况下是通过内镜（PEG）或放射（PRG）胃造口术进行肠内营养。目的：分析置入 PEG/PRG 时 ALS 患者的特征，比较 PRG 与 PEG 的疗效和安全性。方法：这是一项回顾性描述性研究。我们招募了本医院过去 3 年（2021-2023 年）中需要进行胃造口术的所有 ALS 患者（4 例 PEG 和 6 例 PRG）。结果：共纳入 10 名患者，平均年龄为 57 岁。所有患者均有吞咽困难，在置入胃造口术前均接受了口服或管道补充营养。肠内营养的平均持续时间约为 50 个月，胃造口术后 12 个月的死亡率为 30%。PEG 和 PRG 的成功率相似，均未出现并发症。结论：一旦患者有吸入性肺炎风险或体重开始下降，就应立即实施胃造口术。尽管胃造口术对营养的益处已得到充分证实，但目前从诊断到实施胃造口术之间的延迟时间约为 4 年。对于 ALS 和呼吸衰竭患者，PRG 似乎比 PEG 更安全。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutricion hospitalaria 医学-营养学

CiteScore

1.90

自引率

8.30%

发文量

181

审稿时长

3-6 weeks

期刊介绍： The journal Nutrición Hospitalaria was born following the SENPE Bulletin (1981-1983) and the SENPE journal (1984-1985). It is the official organ of expression of the Spanish Society of Clinical Nutrition and Metabolism. Throughout its 36 years of existence has been adapting to the rhythms and demands set by the scientific community and the trends of the editorial processes, being its most recent milestone the achievement of Impact Factor (JCR) in 2009. Its content covers the fields of the sciences of nutrition, with special emphasis on nutritional support.