Percutaneous endoscopic versus radiologic gastrostomy for enteral feeding: a retrospective analysis on outcomes and complications

Denise Strijbos; Daniel Keszthelyi; Lennard P. L. Gilissen; Martin Lacko; Janneke G. J. Hoeijmakers; Christiaan van der Leij; Rogier J. J. de Ridder; Michiel W. de Haan; Ad A. M. Masclee

doi:10.1055/a-0953-1524

Endoscopy International Open, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(11): E1487-E1495
DOI: 10.1055/a-0953-1524

Original article

Percutaneous endoscopic versus radiologic gastrostomy for enteral feeding: a retrospective analysis on outcomes and complications

Denise Strijbos

¹Division of Gastroenterology and Hepatology, Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands

²Department of Gastroenterology and Hepatology, Catharina Hospital Eindhoven, The Netherlands

,

Daniel Keszthelyi

¹Division of Gastroenterology and Hepatology, Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands

,

Lennard P. L. Gilissen

²Department of Gastroenterology and Hepatology, Catharina Hospital Eindhoven, The Netherlands

,

Martin Lacko

³Department of Otorhinolaryngology/Head & Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands

,

Janneke G. J. Hoeijmakers

⁴Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands

,

Christiaan van der Leij

⁵Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands

,

Rogier J. J. de Ridder

¹Division of Gastroenterology and Hepatology, Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands

,

Michiel W. de Haan

⁵Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands

,

Ad A. M. Masclee

¹Division of Gastroenterology and Hepatology, Department of Internal Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands

› Institutsangaben

Abstract

Background and study aims Percutaneous endoscopic gastrostomy (PEG) and percutaneous radiologic gastrostomy (PRG) are techniques used for long-term enteral feeding. Our primary aim was to analyze procedure-related and 30-day mortality and complications between PEG and PRG in relation to indications.

Patients and methods A single-center retrospective analysis was performed thath included all adult patients receiving initial PEG (January 2008 until April 2016) and PRG (January 2010 until April 2016). Outcomes were mortality (procedure-related, 30-day), complications (early (≤ 30 days) and late) and success rates.

Results A total of 760 procedures (469 PRG and 291 PEG) were analyzed. Most common indications were head and neck cancer (HNC), cerebrovascular accident (CVA) and amyotrophic lateral sclerosis (ALS). Success rates for placement were 91.2 % for PEG and 97.1 % for PRG (P = 0.001). Procedure-related mortality was 1.7 % in PEG and 0.4 % in PRG (P = 0.113). The 30-day mortality was 10.7 % in PEG and 5.1 % in PRG (P = 0.481 after multivariate logistic regression) CVA was associated with higher 30-day mortality, whereas ALS, higher body weight, and prophylactic placements in HNC were associated with lower rates.

Tube-related complications were less frequent in PEG, both early (2.7 % vs. 26.4 %, P ≤ 0.001) and late (8.6 % vs. 31.5 %, P ≤ 0.001). The percentage of major complications and infections did not differ.

Conclusions With respect to procedure-related and 30-day mortality, PEG and PRG compare equally. PRG had a higher procedural success rate. Tube-related complications and pain are less frequent after PEG compared to PRG. The choice for either PEG or PRG therefore should primarily be based on local facilities and expertise.

Volltext

Referenzen

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