Percutaneous endoscopic gastrostomy (PEG) using a novel large-caliber introducer technique kit: a retrospective analysis

Abstract

Background and study aims: Percutaneous endoscopic gastrostomy (PEG) using the introducer technique is not only useful in patients with upper digestive tract stenosis but has been shown to reduce peristomal infection. In this study, we evaluated the safety and utility of a novel large-caliber introducer PEG kit (using 20 Fr size tube) compared with a push kit of similar size. Patients and methods: One hundred and thirty-six patients who received PEG at our hospital between January 2014 and December 2015 were retrospectively analyzed. Baseline characteristics, laboratory biomarkers, hemodynamic changes, postoperative adverse events and clinical outcomes with both kits were compared. Results: The new introducer PEG kit was used in 61 patients while the remaining 75 patients received tube placement using a push technique PEG kit. Except for the prevalence of dementia, which was lower in the introducer PEG kit group, baseline characteristics were similar in both groups. Tube placements were 100 % successful with both PEG kits and there were no significant differences in the change of postoperative hemodynamic or laboratory biomarkers. The Introducer PEG kit group experienced fewer incidence of feeding-related aspiration pneumonia (8.2 % vs. 24 %, P = 0.02), lower peristomal infection scores (1.2 vs. 1.6, P < 0.01), shorter postoperative length of stay (16 days vs. 23.7 days, P = 0.01) and fewer deaths at day 60 (3.3 % vs. 16 %, P = 0.02). Conclusions: Gastrostomy using the new large-caliber introducer PEG kit is safe and produced non-inferior (with some favourable) results when compared to the push technique using similar size tubes.

Outcomes of push and pull percutaneous endoscopic gastrostomy placements in 854 patients: A single‐center study

“…PEG placement was successful in 97.5% of the patients, which is similar to reported success rates of at least 95% 4,28,29 . Absence of diaphany was the most common reason for aborting the procedure.…”

Comparison of Pull and Introducer Techniques for Percutaneous Endoscopic Gastrostomy

“…In this study, the most common indications for PEG in both study groups were malignancy followed by neurological disorders, which is different than that reported by Western-based studies. 4 , 12 In addition to the factors associated with disease occurrence and survival time, it also reflects the differences in understanding the benefits of PEG between Chinese and Western doctors, and patients’ lower acceptance of PEG. Patient factors that influence PEG decision-making include appearance, fear of becoming a burden, worry of unknown technology and prognosis, and differences in values and beliefs.…”

“…The suture thread was then caught by closing the loop snare and after the double needle was withdrawn from the stomach, the thread was tied outside the abdominal wall. 12 After local anesthesia, a special trocar was inserted in the center of the two fixations, the needle core was withdrawn, a balloon feeding tube was inserted, and water was infused to complete the internal fixation. The complete procedure for the introducer method is shown in Figure 2 .…”

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

“…Nevertheless, this technique is not widely used because the size of the PEG catheter employed is often small. Recently, large-caliber tubes using this technique, such as in our case, can also be safely inserted without increasing the risk of peristomal infection [ 12 ]. In our patient, the introducer technique was used along with systemic antimicrobial prophylaxis.…”