Tracheostomies and PEGs: When Are They Really Indicated?

Surg Clin North Am. 2019 Oct;99(5):955-965. doi: 10.1016/j.suc.2019.06.009. Epub 2019 Jul 18.

Abstract

Surgeons are often asked to perform tracheostomies and percutaneous endoscopic gastrostomies for a wide variety of patients. As consultants, surgeons are tasked with honoring the relationship between the referring provider and the patient while also assessing whether the consult is appropriate given the patient's prognosis and goals of care. This article discusses the most common conditions for which these procedures are requested and reviews the evidence supporting either the placement or avoidance of these tubes in each condition. It provides a framework for surgeons to use when discussing these procedures in the context of goals of care.

Keywords: Feeding tube; Goals of care; PEG; Tracheostomy.

Publication types

  • Review

MeSH terms

  • Critical Illness / therapy
  • Endoscopy, Gastrointestinal* / adverse effects
  • Endoscopy, Gastrointestinal* / mortality
  • Enteral Nutrition*
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Nervous System Diseases / surgery*
  • Palliative Care / ethics
  • Tracheostomy* / adverse effects
  • Tracheostomy* / mortality
  • Wounds and Injuries / surgery*