Soo-Kyung Park1, Ji Yeon Kim2, Seong-Joon Koh3, Yoo Jin Lee4, Hyun Joo Jang5, Soo Jung Park6. 1. Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 031811, South Korea. 2. Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. 3. Department of Internal Medicine, Seoul University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. 4. Division of Gastroenterology, Department of Internal Medicine, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu, 41931, South Korea. 5. Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, 7 Keunjaebong-gil, Hwaseong-si, Gyeonggi-do, 18450, South Korea. 6. Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea. sjpark@yuhs.ac.
Abstract
BACKGROUND: Gastrostomy tube insertion is beneficial to selected patients, and percutaneous endoscopic gastrostomy (PEG) and percutaneous radiological gastrostomy (PRG) are two of the frequently used methods in gastrostomy. This study aimed to investigate the indications and complications of both PEG and PRG. METHODS: This was a retrospective multicenter cohort study. Patients who underwent initial PEG or PRG tube insertion for nutritional purpose between January 2010 and December 2015 at five university hospitals were included in the study. We analyzed the indications and all complications related to gastrostomy, which were divided into the major (systemic or life-threatening) and minor (local and non-life-threatening) categories. RESULTS: A total of 418 patients who underwent PEG (n = 324) and PRG (n = 94) were reviewed. The indications for gastrostomy tube insertion were different and included mainly neurological disease (n = 240, 74.1%) such as cerebrovascular accident in the PEG group (n = 119, 36.7%) and mainly surgical disease (n = 28, 29.8%) such as head and neck cancer (n = 16, 17.0%) in the PRG group (p = 0.05). There were no differences in the minor (16.4% vs. 19.1%, p = 0.52) and major (12.3% vs. 14.9%, p = 0.51) complication rates between the PEG and PRG groups. The risk factors for complications were age [yearly increments; odds ratio (OR) 1.03, 95% confidence interval (CI) 1.01-1.06], tube diameter (1-Fr increments; OR 1.26, 95% CI 1.01-1.58), insertion time (1-min increments; OR 1.07, 95% CI 1.01-1.13), and neurological disease as the gastrostomy indication (vs. surgical disease; OR 4.61 95% CI 1.47-14.42). CONCLUSIONS: In our study, both PEG and PRG provided a safe route for nutrition delivery despite their different indications. Our data suggest that PEG might be the procedure of choice for patients with medical or neurological disease and PRG for patients with surgical disease in whom PEG is technically difficult or contraindicated.
BACKGROUND: Gastrostomy tube insertion is beneficial to selected patients, and percutaneous endoscopic gastrostomy (PEG) and percutaneous radiological gastrostomy (PRG) are two of the frequently used methods in gastrostomy. This study aimed to investigate the indications and complications of both PEG and PRG. METHODS: This was a retrospective multicenter cohort study. Patients who underwent initial PEG or PRG tube insertion for nutritional purpose between January 2010 and December 2015 at five university hospitals were included in the study. We analyzed the indications and all complications related to gastrostomy, which were divided into the major (systemic or life-threatening) and minor (local and non-life-threatening) categories. RESULTS: A total of 418 patients who underwent PEG (n = 324) and PRG (n = 94) were reviewed. The indications for gastrostomy tube insertion were different and included mainly neurological disease (n = 240, 74.1%) such as cerebrovascular accident in the PEG group (n = 119, 36.7%) and mainly surgical disease (n = 28, 29.8%) such as head and neck cancer (n = 16, 17.0%) in the PRG group (p = 0.05). There were no differences in the minor (16.4% vs. 19.1%, p = 0.52) and major (12.3% vs. 14.9%, p = 0.51) complication rates between the PEG and PRG groups. The risk factors for complications were age [yearly increments; odds ratio (OR) 1.03, 95% confidence interval (CI) 1.01-1.06], tube diameter (1-Fr increments; OR 1.26, 95% CI 1.01-1.58), insertion time (1-min increments; OR 1.07, 95% CI 1.01-1.13), and neurological disease as the gastrostomy indication (vs. surgical disease; OR 4.61 95% CI 1.47-14.42). CONCLUSIONS: In our study, both PEG and PRG provided a safe route for nutrition delivery despite their different indications. Our data suggest that PEG might be the procedure of choice for patients with medical or neurological disease and PRG for patients with surgical disease in whom PEG is technically difficult or contraindicated.
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