The role of the nurse in nursing care of a patient with a percutaneous endoscopic gastrostoma

Perkutana endoskopska gastrostoma (PEG) je metoda postavljanja sonde kroz trbušnu stijenku izravno u želudac uz pomoć endoskopa, u svrhu dugotrajne enteralne prehrane. Prvi put je izvedena 1979. godine, a godinu dana kasnije su ju objavili dr. M.W.L. Gauderer i dr. J.L. Ponsky. Zahvat je relativno brz i jednostavan te ne zahtjeva opću anesteziju, čime se izbjegava mogućnost razvoja komplikacija intubacije. PEG omogućuje unos potrebnih nutrijenata, tekućine i lijekova direktno u želudac kod pacijenata koji nisu u stanju uzimati hranu oralnim putem. Brojne su indikacije za postavljanje PEG-a, a najviše se primjenjuje kod pacijenata s neurološkim bolestima, orofaringealnim tumorima te cerebrovaskularnim bolestima. Moguće komplikacije nakon postavljanja PEG-a su: krvarenje, infekcija, peristomalno propuštanje, fistula, ileus... Međutim, rizik od nastanka komplikacija tijekom i nakon plasiranja PEG-a se može svesti na minimum ukoliko se pravilno postupa tijekom zahvata te ukoliko se stoma i okolno tkivo svakodnevno pravilno njeguju. Perkutana endoskopska gastrostoma je zbog iznimne efikasnosti i sigurnosti i 30 godina nakon njenog objavljivanja među vodećim metodama za dugotrajnu enteralnu prehranu. Njenim postavljanjem se sprječava gubitak tjelesne težine, unose se sve potrebne kalorijske vrijednosti te se poboljšava kvaliteta pacijentova života.Percutaneous endoscopic gastrostomy (PEG) is a method of placing a tube through the abdominal wall directly into the lumen of the stomach with help of a endoscope, with the intention of providing long-term enteral feeding. The first time it has been perfomed was in 1979 and a year later it was published by dr. Michael W.L. Gauderer and dr. Jeffrey L. Ponsky. The procedure is relatively fast and simple and it does not require the need of general anesthesia, which avoids the possibility of developing intubation complications. PEG allows the intake of required nutrients, fluids and medications directly into the stomach in patients who can not digest food oraly. There are many indications for the placement of the PEG tube. It is mostly placed in patients with neurological diseases, oropharyngeal malignancy and cerebrovascular diseases. Possible complications after the PEG tube placement are: bleeding, infection, peristomal leakage, fistula, ileus... However, the risk of development of complications during and after the PEG tube placement can be minimized when it is managed properly during the procedure and when the stoma site and skin around the stoma is daily taken care of. Percutaneous endoscopic gastrostomy is, because of the exceptional efficiency and safety, even 30 years after it has been published one of the leading methods for longterm enteral feeding. The placement of the PEG tube prevents weight loss, allows the intake of all required calories and improves the patients quility of life