Sara L Zettervall1, Jeremy L Holzmacher2, Michal Radomski2, Matthew Skancke2, Justin Shafa2, Richard Amdur2, Babak Sarani2, Khashayar Vaziri2. 1. Department of Surgery, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave. NW, Suite 6B, Washington, DC, 20037, USA. slzettervall@gmail.com. 2. Department of Surgery, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave. NW, Suite 6B, Washington, DC, 20037, USA.
Abstract
INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) and laparoscopic gastrostomy (LG) placements provide enteral access to patients unable to tolerate oral feeds. Limited data comparing PEG and LG outcomes is available in adults. This study compares complications between PEG and LG placements. MATERIALS AND METHODS: A retrospective chart review was completed for patients undergoing PEG or LG placement at a single academic center between 2007 and 2014. Patient demographics, comorbidities, and Charlson Comorbidity Index (CCI) were compared. Logistic regression was utilized to identify independent predictors for complication. RESULTS: Two hundred and twenty-four patients (164 PEGs and 60 LGs) were evaluated. Patients undergoing LG had a higher incidence of prior surgery (42 vs 20%; P < 0.01) and age-adjusted CCI (5 vs 4; P = 0.01). Return to the OR was more common following PEG than LG (5.5 vs 0%) but did not achieve significance (P = 0.12). There were no differences in 30-day mortality; however, age-adjusted CCI was predictive of 30-day mortality (OR 1.3, 95% CI 1.1-1.6). CONCLUSION: Despite increased comorbidities, LG tubes are at least as safe as PEGs. Research should focus on identifying predictive factors associated with post-operative complications to identify which patients would have superior outcomes with LG placement.
INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) and laparoscopic gastrostomy (LG) placements provide enteral access to patients unable to tolerate oral feeds. Limited data comparing PEG and LG outcomes is available in adults. This study compares complications between PEG and LG placements. MATERIALS AND METHODS: A retrospective chart review was completed for patients undergoing PEG or LG placement at a single academic center between 2007 and 2014. Patient demographics, comorbidities, and Charlson Comorbidity Index (CCI) were compared. Logistic regression was utilized to identify independent predictors for complication. RESULTS: Two hundred and twenty-four patients (164 PEGs and 60 LGs) were evaluated. Patients undergoing LG had a higher incidence of prior surgery (42 vs 20%; P < 0.01) and age-adjusted CCI (5 vs 4; P = 0.01). Return to the OR was more common following PEG than LG (5.5 vs 0%) but did not achieve significance (P = 0.12). There were no differences in 30-day mortality; however, age-adjusted CCI was predictive of 30-day mortality (OR 1.3, 95% CI 1.1-1.6). CONCLUSION: Despite increased comorbidities, LG tubes are at least as safe as PEGs. Research should focus on identifying predictive factors associated with post-operative complications to identify which patients would have superior outcomes with LG placement.
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