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Ann Geriatr Med Res  <  Volume 23(1); 2019 <  Articles

Ann Geriatr Med Res 2019; 23(1): 27-30  https://doi.org/10.4235/agmr.19.0006
Percutaneous Endoscopic Gastrostomy Tube Removal for Patients With Advanced Dementia: Case Series Study
Yukari Hattori1, Taro Kojima1 , Hiroaki Komura2, Nobuyuki Ura2, Masahiro Akishita1
1Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, 2Sapporo Nishimaruyama Hospital, Sapporo, Japan
Correspondence to: Taro Kojima, MD, PhD, https://orcid.org/0000-0003-3857-5267
Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan, E-mail: tkojima-tky@umin.ac.jp
Received: February 13, 2019; Revised: March 15, 2019; Accepted: March 21, 2019; Published online: March 31, 2019.
© The Korean Geriatrics Society. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Although the notion of percutaneous endoscopic gastrostomy (PEG) tube placement for patients with dementia has been changing, the number of cases of PEG placement remains high as Japan has become a super-aged society. However, there is insufficient research about the clinical course of dementia patients with PEG, especially regarding PEG extubation after regaining full oral intake. This case series aimed to reveal the demographic data of patients who successfully underwent PEG extubation and to identify clinical factors that might help predict eventual resumption. Methods: This retrospective case series was identified in a private, community-based long-term care hospital in Sapporo, Japan. Inclusion criteria for the series were: 1) age, ≥75 years, 2) diagnosis of any type of dementia, and 3) resumption of full oral intake after removal of PEG tubes. Results: Eight female patients were identified. Decreased oral intake was triggered by acute medical conditions, such as infectious enteritis. A trial of oral intake was initiated mostly by speech therapists. A majority of the patients ate pureed food. The patients aged ≥85 years with advanced dementia could be weaned from PEG tubes. Conclusion: The series indicates that even patients with limited life expectancy could recover swallowing function by receiving appropriate guidance and care. Constant evaluation for swallowing function even after PEG insertion may be important for PEG extubation.
Keywords: Deglutition disorders, Dementia, Gastrostomy


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