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118 COMPARATIVE STUDY OF NURSE ASSISTED PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (NAPEG) TO PHYSICIAN ASSISTED ENDOSCOPIC GASTROSTOMY (PAPEG): A RETROSPECTIVE CHART REVIEW T Guzowski, S Gregoire, MC Champion BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) has become the standard primary intervention for providing long term nutrition to patients with persistant dysphagia. PEG tubes are routinely inserted by trained gastroenterologists or surgeons. Normally the operator requires a resident or assistant to hold his endoscope in place while he/she performs the percutaneous insertion of the gastrostomy catheter. At our centre, registered nurses have been trained to perform the percutaneous insertion of the gastrostomy catheter on their own, with the physician operating the endoscope.
Department of Gastroenterology, University of Ottawa, Ottawa, Ontario
This study compares PAPEG with NAPEG in terms of safety and effectiveness.
METHODS: This study is a retrospective chart review of 97 PEG tube insertions performed at our centre between 2004 and 2006. 57% (55) of these were performed with nurse assistance and 44% (43) with resident physician assistance.
The indication for the procedure, success, duration and complication rates were recorded. Patient demographics from both study groups were compared.
RESULTS: All of the procedures were successfully completed in each group. The average operative time for PAPEG was 17 min compared to 15 min for NAPEG. The rate of complications within the first month after insertion or up to the time of discharge from hospital was 3% vs 2 % major (significant aspiration, peritonitis, death) and 7% vs. 6.5% minor (leaking of tube, oozing/discharge at site) for PAPEG and NAPEG respectively.
CONCLUSION: Our findings show that NAPEG is as effective and safe as PAPEG while the time required to perform a NAPEG is actually shorter in comparison. In a centre with trained endoscopy nurse assistants NAPEG is the preferred procedure for gastrostomy tube placement.