دانلود رایگان مقاله تاثیر جایگزین گاستروستومی اندوسکوپیک در بیماری ریفلاکس معده

Summary

Background: The occurrence rate and severity of gastroesophageal reflux disease with erosive esophagitis (EE) in patients after converting nasogastric tube (NGT) feeding to percutaneous endoscopic gastrostomy (PEG) are not well-known. The aim of this study was to determine the influence of PEG placement on the occurrence and severity of EE in patients with long-term PEG feeding. Methods: This retrospective study included patients with NGT feeding who were converted to PEG feeding and received pre- and post-PEG endoscopy between January 2000 and June 2013. Factors predictive of the occurrence of EE after PEG were analyzed. Results: One-hundred and twenty patients with NGT feeding were converted to PEG, and 47 patients were included. Before PEG, 21 (44.7%) NGT-feeding patients had EE. The mean follow-up time was 45.7 months (range, 6e147 months). Erosive esophagitis occurred in nine (19.1%) patients after PEG. The occurrence rate (p < 0.01) and severity (p < 0.05) of EE significantly improved after PEG, compared to before PEG. Hill’s classification of gastroesophageal valve was associated with the occurrence of EE after PEG (p < 0.01) Conclusion: The occurrence and severity of esophagitis improved after converting the patient to PEG. Hill’s grading of gastroesophageal valve provides useful information for predicting the occurrence of EE after PEG.

Discussion

We described the influence of PEG replacement on EE in patients with a swallowing disorder with endoscopic examination. In this study, 21 (44.7%) of 47 NGT-feeding patients had EE before they underwent the PEG operation (Table 1). Erosive esophagitis occurred only in nine (19.1%) patients after receiving PEG, and no patient without preexisting EE developed EE after receiving PEG (Table 2). Our study results imply that approximately one-half of NGT feeding patients had EE before receiving PEG, and that PEG did not worsen or precipitate EE.