Outcome of percutaneous endoscopic gastrostomy insertion in patients with amyotrophic lateral sclerosis in relation to respiratory dysfunction

• Published in: Amyotrophic lateral sclerosis and frontotemporal degeneration 2013-12, Vol.14 (7-8), p.528-532
• Main Authors: Sarfaty, Michal, Nefussy, Beatrice, Gross, Ditza, Shapira, Yami, Vaisman, Nachum, Drory, Vivian E.
• Format: Article
• Language: English
• Subjects: Amyotrophic lateral sclerosis; Amyotrophic Lateral Sclerosis - mortality; Amyotrophic Lateral Sclerosis - surgery; Female; forced vital capacity; Gastroscopy - trends; Gastrostomy - trends; Humans; Male; Middle Aged; motor neuron disease; percutaneous endoscopic gastrostomy; Respiration Disorders - mortality; Respiration Disorders - surgery; respiratory dysfunction; Retrospective Studies; Survival Rate - trends; Treatment Outcome; Vital Capacity - physiology
• ISSN: 2167-8421; 2167-9223
• DOI: 10.3109/21678421.2013.812659

Abstract Our objective was to describe a group of ALS patients who underwent percutaneous endoscopic gastrostomy (PEG) insertion, with emphasis on the respiratory function, by comparing patients with forced vital capacity (FVC) > 30% versus FVC ≤ 30%, and the effect of respiratory dysfunction on the perioperative complication rate and survival. Thirty consecutive ALS patients in whom FVC status was known underwent PEG insertion at our centre. Twenty of them had FVC > 30% (50.1% ± 20) at the time of the procedure, and 10 had FVC ≤ 30% (20.1% ± 7). Demographic and clinical data were reviewed in each patient. Results showed that all patients had successful PEG insertion without any complications. There was no statistically significant difference between the two FVC groups regarding survival after the date of PEG insertion. In conclusion, in this relatively small patient sample there was no difference in complication rate and survival after PEG insertion between patients with poor respiratory function (FVC ≤ 30%) at the time of the procedure and patients with better respiratory function (FVC > 30%). Therefore, according to our data, PEG insertion may be regarded as safe even in patients with low FVC and should be offered even to patients with respiratory dysfunction.