Effect of the introducer technique compared with the pull technique on the peristomal infection rate in PEG: a meta-analysis

Campoli, Paulo Moacir de Oliveira; Paula, Adriano Augusto Peclat de; Alves, Luana Gomes; Turchi, Marília Dalva

doi:10.1016/j.gie.2012.01.003

Cited by 29 publications

(30 citation statements)

References 38 publications

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“…PEG using the introducer technique, in which the gastrostomy tube is inserted without passing through the oral cavity, has also been associated with lower peristomal infection rates compared to conventional pull/push techniques [11]. Nevertheless, this technique is not widely used because the size of the PEG catheter employed is often small.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Endoscopic Gastrostomy in a Patient With Continuous Intrathecal Baclofen Infusion Therapy

Yoon

Kobayashi²

2017

Gastroenterol Res

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Percutaneous endoscopic gastrostomy (PEG) is the method of choice in patients requiring long-term enteral tube feeding. In patients with intrathecal baclofen infusion therapy (IBT) pump implantation, infection via the skin and soft tissue may be an issue of concern. The introducer technique for gastrostomy tube insertion may be useful in reducing the risk of peristomal infection. Although the presence of a PEG tube has been reported as a risk factor for implantation site infection (for newly inserted IBT pumps), whether existing IBT pumps are at risk for infection during or after the placement of a PEG tube is not clear. We report a case where PEG was successfully performed using the introducer technique on a patient with an IBT pump implant.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Endoscopic Gastrostomy in a Patient With Continuous Intrathecal Baclofen Infusion Therapy

Yoon

Kobayashi²

2017

Gastroenterol Res

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“…Patients with head and neck cancer suffer from bacterial overgrowth in the oral cavity and throat [20,21] . DP technique seems to be associated with lower risk of infections as it eliminates the threat of pharyngeal bacteria spread into the stoma [22] . Dormann et al [23] recommended the use of the direct technique in MRSA-positive patients to reduce PEG site infections.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Endoscopic Gastrostomy in Direct Puncture Technique: When, Why and How?

Schaefer¹,

Vivaldi²,

Herbold³

et al. 2016

Dig Surg

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Background: Percutaneous endoscopic gastrostomy (PEG) placed in the pull through (PT) technique is a common procedure to restore enteral feeding in patients with swallowing disorders. Limitations of this technique are patients with obstruction of the pharynx or esophagus or with an esophageal stent. We report our experience with the direct puncture (DP) PEG device. Methods: We included 154 patients (55 women). One hundred forty patients had cancer. After passing the endoscope into the stomach, 4 gastropexies were performed with a gastropexy device and the PEG was placed with the introducer method. After 1 month, the sutures were removed and a constant gastrocutaneous fistula had been created and the new catheter could be placed safely. Results: The DP PEG was successfully placed in all patients. Overall complication rate was 11% (minor: 6%, major: 5%). The most common event was tube dislocation (40 cases). In 5 cases of dislocation, this resulted in a major complication with injuring the gastric wall and the necessity for surgical treatment. Conclusions: The DP PEG system is safe, and can be used in cases in which a standard PT PEG is not feasible. To avoid dislocation, strict adherence to a post-interventional protocol is highly recommended.

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“…There is data for RIG showing no wound infections [466]. In general, the introducer technique has a lower infection rate [465]. Data from US-guided techniques are not available but may be extrapolated from data for RIG.…”

Section: Recommendation 57mentioning

confidence: 99%

“…An alternative is the introducer technique ("push" technique). There is evidence that the introducer technique causes fewer peristomal infections [464,465].…”

Section: Introductionmentioning

confidence: 99%

Untitled

2016

Ultraschall in Med

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Effect of the introducer technique compared with the pull technique on the peristomal infection rate in PEG: a meta-analysis

Cited by 29 publications

References 38 publications

Percutaneous Endoscopic Gastrostomy in a Patient With Continuous Intrathecal Baclofen Infusion Therapy

Percutaneous Endoscopic Gastrostomy in a Patient With Continuous Intrathecal Baclofen Infusion Therapy

Percutaneous Endoscopic Gastrostomy in Direct Puncture Technique: When, Why and How?

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