Role of Surgical Feeding Gastrostomy in Patients Requiring Prolonged Nutrition in a Neurosurgical Department

Abstract

Objective: To build up the nutritional status of the neurosurgical patients with an easy and practical way.
Patients and Methods: This prospective study was conducted in Neurosurgery department of Pakistan Institute of Medical Sciences Islamabad in a six months’ time. In total thirty adult patients of either gender with H/O road traffic accident with severe head injury and GCS less than 8/15, persistent vegetative state, brain tumor patients who had developed lower cranial nerve palsies were included in the study. 28 for two way Foleys catheter was used in feeding gastrostomy. Results: Thirty patients, with the median age of 35 years (range, 18-55 years) underwent feeding gastrostomy. Before the gastrostomy tube insertion, 18 patients had enteral nutrition by a nasogastric tube and 10 had parenteral nutrition (PN), with a median duration of 14.5 (range, 4-60) and 12 (range, 7-25) days, respectively. Two patients accidentally pulled out the gastrostomy tubes 10 and 11 days after insertion. Buried bumper syndrome developed in 1 patient. Two patients died 8 and 34 days after the procedure in the neurosurgical ICU. Twenty-eight patients were discharged from the hospital while being fed via the gastrostomy tubes. In 11 patients who were able to resume oral feeding, the tube was removed, with a median interval of 62 (range, 25-150) days. There was no Procedure-related mortality.
Conclusion: An improvised method of nutritional support according to our circumstances. This study can be extended to other surgical and medical patients who need nutritional support for longer period of time.