Journal of Multidisciplinary Healthcare (Apr 2022)

Comparison of Pull and Introducer Techniques for Percutaneous Endoscopic Gastrostomy

  • Li X,
  • Wang JX,
  • Wang YP,
  • Shen JX,
  • Zheng YX,
  • Zhang PH,
  • Wei JJ,
  • Zhuang ZH

Journal volume & issue
Vol. Volume 15
pp. 733 – 741

Abstract

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Xia Li,1,2 Jun-Xi Wang,1 Yu-Ping Wang,1 Jia-Xin Shen,1 Yi-Xing Zheng,1 Pei-Hong Zhang,1 Jing-Jing Wei,1 Ze-Hao Zhuang1 1Endoscopy Center, First Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 2Endoscope Room, Changle District Hospital, Fuzhou, People’s Republic of ChinaCorrespondence: Ze-Hao Zhuang, Endoscopy Center, First Affiliated Hospital of Fujian Medical University, 20, Chazhong Road, Taijiang District, Fuzhou, 350005, Fujian Province, People’s Republic of China, Tel +860591-87981370, Fax +860591-87981371, Email [email protected]: To compare indications, success rates and complications of pull [P] and introducer [I] techniques for percutaneous endoscopic gastrostomy (PEG).Methods: In this retrospective study, inpatients who underwent primary PEG tube insertion between January 2015 and February 2020 at the Endoscopy Center of the First Affiliated Hospital of Fujian Medical University were included.Results: A total of 103 inpatients were included in this study (P group, n = 67; I group, n = 36). The rates of tube replacement within first six months in the P and I groups were 1.5% and 11.1%, respectively (P = 0.049). The most common primary indication of PEG was malignancy. The proportion of patients with esophageal cancer was significantly lower in the P group (24.4% vs 54.2%, P = 0.015). No significant difference was found in the overall, major, or minor complications between the two groups. In patients with esophageal stenosis, the pull method was a risk factor for complications (P = 0.03; odds ratio [OR] = 12, 95% confidence interval [CI]: 1.164– 123.684). Logistic regression analysis showed that the risk factors for major and minor complications were the admission-to-gastrostomy interval (OR = 1.078, 95% CI: 1.016– 1.145, P = 0.014) and lack of antibiotic use (OR = 4.735, 95% CI: 1.247– 17.979, P = 0.022), respectively.Conclusion: Both PEG techniques have high clinical success rates. The introducer technique is more suitable for patients with esophageal stricture, which has lower minor complications, but higher rate of tube replacement compared to the pull technique. Use of antibiotics may reduce minor complications following PEG. Early PEG insertion may help to reduce post-PEG major complications.Keywords: endoscopy, gastrostomy, enteral nutrition, indications, complications

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