Abstract
Percutaneous endoscopic gastrostomy (PEG) is an endoscopic surgery first reported by Ponsky and Gauderer in 1980. Due to its safety, convenience, and economy it has already spread worldwide as the first choice for gastrogavage in treating oral ingestion difficulties due to disease and for decompression in treating malignant bowel obstruction. In Japan, such actions as the development of new techniques in PEG surgery, innovations in catheter replacement, country-wide public awareness activities regarding after-care, and improvements in nutritional care through the development and spread of Nutrition Support Teams have resulted in improvements in patients' quality of life and achieved long-term prognoses unparalleled in the world. On the other hand, we also see a movement to re-examine the suitability of PEG from an ethical point of view in patients such as those in the final stages of dementia. Further discussion is needed on this issue.
In addition, one characteristic specific to PEG is that in general the endoscopist performing the procedure and the doctor in charge of after-care are different. The surgical (acute care hospitals) and after-care facilities (long-term care, geriatric health services facilities, private homes) also differ, easily leading to problems. Because of this, we need medical care from a multi-disciplinary team and with local coordination.
