INVESTIGATION OF A PREOPERATIVE PREDICTION OF FUNCTIONAL IMPROVEMENT IN ORAL INTAKE AFTER PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

Abstract

[Purpose]A percutaneous endoscopic gastrostomy (PEG) is a safe and effective way to provide food, liquids and medications directly into the stomach. The procedure is performed in patients with difficulty swallowing. Indications for selecting individuals for PEG remain a matter of debate. In this study, we retrospectively investigated the relation between the clinical parameters before PEG and improvement in oral intake function after PEG. [Methods]Eighty-five patients were enrolled in this study and their swallowing function was assessed based on Fujishima's swallowing function grades. The preoperative clinical parameters were analyzed by Student's t test and χ2-test, and then the parameters which showed higher p value (>0.2) were evaluated by logistic regression analysis. [Results]Multivariate analysis showed that the swallowing function before PEG (Fujishima grade >=3) was a significant independent determinant of improvement in oral intake function after PEG. These results provide support that an objective numerical evaluation of swallowing function is useful for selecting patients optimally suited for PEG feeding. [Conclusion] Nutritional improvement by PEG feeding and rehabilitation of swallowing ability could contribute to functional improvement in oral intake in patients with modest retention of the ability to swallow before PEG.