BACKGROUND: Although pull percutaneous endoscopic gastrostomy (Pull-PEG) is a commonly used procedure, peristomal infection and tumor implantation are considered unavoidable complications of this procedure as the instrument passes through the oral cavity. A novel extracorporeal PEG technique, Direct-PEG, has been developed to reduce the risk of peristomal infection and implantation. STUDY DESIGN: The Direct-PEG procedure was performed on 87 patients from April 2006 to April 2007 in a single, high-volume cancer center in Japan. To compare the surgical outcomes of Direct-PEG and Pull-PEG, the clinical outcomes of Direct-PEG, such as peristomal infection, were retrospectively collected and compared with those of 64 patients having Pull-PEG procedures from April 2005 to March 2006. RESULTS: The mean operation time for the Direct-PEG group (13+/-1 minutes) was comparable to that for the Pull-PEG group (12+/-1 minutes), and the mean visual analogue pain score during surgery was lower for the Direct-PEG group (3.5+/-1.7) than for the Pull-PEG group (24.6+/-3.6; p < 0.001). The incidence of peristomal infection was lower in the Direct-PEG group (1%) than in the Pull-PEG group (9%; p=0.001). Although the most common major underlying disease in the groups was oropharyngeal or esophageal tumor, tumor implantation was not observed in either group. CONCLUSIONS: Direct-PEG may be superior to the Pull-PEG method for a high-volume cancer center because of reduced risks of infection.
BACKGROUND: Although pull percutaneous endoscopic gastrostomy (Pull-PEG) is a commonly used procedure, peristomal infection and tumor implantation are considered unavoidable complications of this procedure as the instrument passes through the oral cavity. A novel extracorporeal PEG technique, Direct-PEG, has been developed to reduce the risk of peristomal infection and implantation. STUDY DESIGN: The Direct-PEG procedure was performed on 87 patients from April 2006 to April 2007 in a single, high-volume cancer center in Japan. To compare the surgical outcomes of Direct-PEG and Pull-PEG, the clinical outcomes of Direct-PEG, such as peristomal infection, were retrospectively collected and compared with those of 64 patients having Pull-PEG procedures from April 2005 to March 2006. RESULTS: The mean operation time for the Direct-PEG group (13+/-1 minutes) was comparable to that for the Pull-PEG group (12+/-1 minutes), and the mean visual analogue pain score during surgery was lower for the Direct-PEG group (3.5+/-1.7) than for the Pull-PEG group (24.6+/-3.6; p < 0.001). The incidence of peristomal infection was lower in the Direct-PEG group (1%) than in the Pull-PEG group (9%; p=0.001). Although the most common major underlying disease in the groups was oropharyngeal or esophageal tumor, tumor implantation was not observed in either group. CONCLUSIONS:Direct-PEG may be superior to the Pull-PEG method for a high-volume cancer center because of reduced risks of infection.
Authors: Felipe A Retes; Fabio S Kawaguti; Marcelo S de Lima; Bruno da Costa Martins; Ricardo S Uemura; Gustavo A de Paulo; Caterina Mp Pennacchi; Carla Gusmon; Adriana Vs Ribeiro; Elisa R Baba; Sebastian N Geiger; Mauricio P Sorbello; Marco A Kulcsar; Ulysses Ribeiro; Fauze Maluf-Filho Journal: United European Gastroenterol J Date: 2016-07-21 Impact factor: 4.623
Authors: Niels Teich; Lars Selig; Susanne Liese; Franziska Schiefke; Alexander Hemprich; Joachim Mössner; Ingolf Schiefke Journal: Endosc Int Open Date: 2018-01-12