Introducere: Alimentatia enterala (AE) este de obicei metoda preferata fata de cea parenterala la pacientii cu un sistem gastrointestinal (GI) functional, datorita riscurilor asociate caii intravenoase, costului mai mare si compromiterea ulterioara a barierei de aparare intestinala. Percutaneous endoscopic gastrostomy (PEG) este in prezent considerata metoda de electie pentru AE pe termen mediu si lung, care permite restabilirea statutului nutritional al pacientului cu riscuri minore. Material si metode: Lotul de studiu a constituit 38 pacienti, care au necesitat AE de lunga durata. Majoritatea pacientilor sufereau de patologii neurologice (76,31%), si traume cranio-cerebrale (23,68%). In perioada 2015-2022, la toti pacientii a fost aplicata PEG dupa metoda GauravArora, folosind setul standard t”Nutricia” (Elvetia). Toate operaile au fost efectuate sub anestezie locala. Perioada de mentinere a gastrostomei, in functie de caz, a fost de la 6 luni pana la 5 ani. Rezultate: Instalarea PEG a fost reusita la toti cei 38 (100%) pacienti. La majoritarea pacientilor 33 (86,84%) s-a constatat o crestere a indicelui masei corporale in primele 6 luni dupa aplicarea PEG. Au fost inregistrate urmatoarele complicatii postoperatorii: infectia plagii – 3(7,89%); sindromul mansonului de protectie ingropat (buried bumper syndrome) - 2(5,26%); (tensiunea excesiva intre mansonul intern si extern determina necroza ischemica a peretelui gastric si, ulterior, migrarea tubului catre peretele abdominal); scurgeri parastomale -1(2,63%); blocarea tubului 1(2,63%). Concluzii: PEG este o medoda fezabila de AE la bolnavii cu sistem gastro-intestinal functional, care necesita alimentatie de lunga durata. Managementul corect al tuburilor PEG intra- si postoperator poate preveni o serie de complicatii a acestei interventii.

Introduction: Enteral nutrition (EN) is usually the preferred method over parenteral nutrition in patients with a functional gastrointestinal system (GIS), due to the associated risks of the with the intravenous route, higher cost, and subsequent compromise of the gut defense barrier. Percutaneous endoscopic gastrostomy (PEG) is currently considered the method of choice for mid- and long-term EN, which allows the restoration of the nutritional status of the patient with minor risks. Material and methods: The study group included 38 patients who required long-term EN. Most of the patients suffered from neurological pathologies (76.31%), and craniocerebral trauma (23.68%). In the period 2015-2022, PEG was applied to all patients according to the GauravArora method, using the standard set ""Nutricia"" (Switzerland). All operations were performed under local anesthesia. The period of maintenance of the gastrostomy, depending on the case, was from 6 months to 5 years. Results: PEG placement was successful in all 38 (100%) patients. In the majority of patients, 33 (86.84%), an increase in body mass index was found in the first 6 months after PEG application. The following postoperative complications were attested: wound infection – 3 (7.89%); buried bumper syndrome - 2(5.26%); (excessive tension between the internal and external bumpers causes ischemic necrosis of the gastric wall and subsequently migration of the tube toward the abdominal wall); parastomal leakage -1 (2.63%); tube blockage – 1 (2.63%). Conclusions: PEG is a feasible method of EN in patients with a functional gastrointestinal system who require longterm nutrition. The correct management of intra- and postoperative PEG tubes can prevent a number of complications of this intervention.