Plus-Hex CLINICAL
Percutaneous endoscopic gastrostomy tube
Gastrostomy or percutaneous endoscopic gastrostomy ( PEG ) tubes are placed through the abdominal wall into the stomach ( Figure 4 ) and can be placed either surgically or endoscopically , depending on the case . Placing the tube endoscopically is a less invasive method and avoids abdominal surgery . However , if the patient needs a coeliotomy due to the presenting problem , the PEG tube can be placed at this time .
PEG tubes cannot be used in the first 24 hours after placement , as this allows time for the stomach and body wall to create a seal . Using the tube prematurely without waiting for the seal to form can put the patient at risk of peritonitis from the leakage of gastrointestinal ( GI ) contents [ 10 ] .
PEG tubes need to be in place for a minimum of 10 days before their removal . The tube can be removed from the conscious patient , although some sedation may be required depending on the patient ' s demeanour . A suture may also be required to close the stoma site .
There are pros and cons of each of type of feeding tube , which are highlighted in Table 1 .
Figure 4 . Percutaneous endoscopic gastrostomy tube in a dog .
Table 1 . Pros and cons of each type of feeding tube .
Type of tube Pros Cons
Naso-oesophageal ( N-O ) • Quick and easy to place
• Can be placed while the patient is conscious ( beneficial in critical patients )
• Avoids the risk of a surgical site infection
• Allows the patient to eat and drink
• VNs can place Oesophagostomy ( O ) • Relatively simple to place
• Larger-bore tube compared with the N-O tube
• Patients often tolerate well
• Can be used at home
• Suitable for long-term use
• Can be used to deliver medication
• Narrow tube , which is at risk of blockage
• Not always tolerated by patients
• Short-term use only ( 5 – 10 days )
• Risk of tracheal intubation
• Risk of tube displacement
• Not suitable for delivery of medications or certain liquid diets
• Requires a general anaesthetic to place
• Risk of surgical site infection
• Risk of tube displacement
• Risk of tube blockage
Percutaneous endoscopic gastrostomy ( PEG )
• Suitable for long-term use ( up to several months )
• Bypasses the oesophagus ( beneficial for oesophageal tears )
• Can be used to deliver medication
• Requires a general anaesthetic to place
• Risk of surgical site infection
• Cannot be used in the first 24 hours after placement
• Must be in place for a minimum of 10 days before removal
Volume 39 ( 6 ) • December 2024
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