Trials of percutaneous endoscopic gastrostomy by transnasal endoscopy using a small-caliber endoscope

We performed percutaneous endoscopic gastrostomy (PEG) by transnasal endoscopy using a small-caliber endoscope for the purpose of relieving the pain and stress of gastrointestinal endoscopy and PEG without conscious cedation. The usefulness and safety were compared between cases performed PEG by transnasal endoscopy and those by transoral endoscopy. Cases with dysphagia by neurological diseases were divided into two groups randomly. The pull technique was used for both groups. We observed vital signs etc to compare pain and stress in transnasal insertion group and transoral insertion group. An increase in blood pressure and pulse rate was significantly small during PEG in the transnasal insertion group compared to the transoral group. There was no major complication in the transnasal insertion group as well as the transoral group. Our experience suggested that PEG by transnasal endoscopy using a small -caliber endoscope is more useful than PEG by transoral endoscopy to relieve the pain and stress, and PEG by transnasal endoscopy is a safe method as well as PEG by transoral endoscopy.