BACKGROUND:Silicone percutaneous endoscopic gastros-tomy (PEG) tubes are associated with more short-term complications and possibly fail sooner than those made of polyurethane. Understanding the deterioration and long-term complications leading to tube failure has important clinical and cost implications. AIM: To compare dwell time and patterns of failure ofsilicone polymer and polyurethane PEG tubes. METHODS: Participants randomized to receive a siliconepolymer (n = 76) or polyurethane (n = 62) PEG werevisited monthly for 540 days, until death or tube removal. Tube and exit site characteristics and reasons for removal were recorded. RESULTS:Tube failure occurred in 25% of silicone PEGs and 12.9% of polyurethane PEGs. Mean tube survival for silicone PEGs was 377.2 days (CI: 326-428) and for polyurethane 436.8 days (CI: 383-490; P = 0.13). A greater proportion of silicone PEGs developed intralumenal colonization and altered tube integrity than polyurethane (P < 0.001). Silicone PEGs blocked more frequently (P < 0.005) and were removed because of irreversible blockage more often than polyurethane PEGs (P < 0.05). Silicone PEGs with reversible blockage and tube integrity changes had a significantly greater probability of failure than silicone tubes without these changes (P < 0.005 and P < 0.05, respectively). CONCLUSIONS: Observations over time indicate that sili-cone PEGs are more susceptible than polyurethane PEGs to tube deterioration, resulting in substantially increased management demands to sustain patients' feeding and medication schedules.
RCT Entities:
BACKGROUND:Silicone percutaneous endoscopic gastros-tomy (PEG) tubes are associated with more short-term complications and possibly fail sooner than those made of polyurethane. Understanding the deterioration and long-term complications leading to tube failure has important clinical and cost implications. AIM: To compare dwell time and patterns of failure ofsilicone polymer and polyurethanePEG tubes. METHODS:Participants randomized to receive a siliconepolymer (n = 76) or polyurethane (n = 62) PEG werevisited monthly for 540 days, until death or tube removal. Tube and exit site characteristics and reasons for removal were recorded. RESULTS:Tube failure occurred in 25% of siliconePEGs and 12.9% of polyurethane PEGs. Mean tube survival for siliconePEGs was 377.2 days (CI: 326-428) and for polyurethane 436.8 days (CI: 383-490; P = 0.13). A greater proportion of siliconePEGs developed intralumenal colonization and altered tube integrity than polyurethane (P < 0.001). SiliconePEGs blocked more frequently (P < 0.005) and were removed because of irreversible blockage more often than polyurethane PEGs (P < 0.05). SiliconePEGs with reversible blockage and tube integrity changes had a significantly greater probability of failure than silicone tubes without these changes (P < 0.005 and P < 0.05, respectively). CONCLUSIONS: Observations over time indicate that sili-cone PEGs are more susceptible than polyurethane PEGs to tube deterioration, resulting in substantially increased management demands to sustain patients' feeding and medication schedules.
Authors: Anand Rajan; Peerapol Wangrattanapranee; Jonathan Kessler; Trilokesh Dey Kidambi; James H Tabibian Journal: World J Gastrointest Surg Date: 2022-04-27
Authors: Niels Teich; Lars Selig; Susanne Liese; Franziska Schiefke; Alexander Hemprich; Joachim Mössner; Ingolf Schiefke Journal: Endosc Int Open Date: 2018-01-12