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Published in:

01-11-2007

Successful new method of extracorporeal percutaneous endoscopic gastrostomy (E-PEG)

Authors: Yoichi Toyama, Teruyuki Usuba, Kyonsu Son, Seiya Yoshida, Ryou Miyake, Ryusuke Ito, Kazuto Tsuboi, Hideyuki Kashiwagi, Hisao Tajiri, Katsuhiko Yanaga

Published in: Surgical Endoscopy | Issue 11/2007

Abstract

Background

Although percutaneous endoscopic gastrostomy (PEG) has become popular for patients with swallowing disorders as a nutrition support or a decompressant of gastrointestine, perioperative complications associated with PEG have not decreased, especially peristomal infections. To reduce peristomal infections, we designed a new method of gastrostomy by extracorporeal approach under endoscopic observation, named as extra-corporeal PEG (E-PEG).

Methods

Experimental studies for E-PEG were performed repeatedly using pigs under general anesthesia to confirm the safty of its procedure for human use. After approval of institutional ethics review board in our university, thirty patients with prior consent participated in this study. The operation time, the incidence rate of complications and the hospital stay were compared between E-PEG and ordinary pull-method PEG groups.

Results

Two patients (6.7%) in E-PEG group had postoperative complications, i.e., aspiration pneumonia and surgical site infection. The operation time of E-PEG group was 5–16 (mean ± SD: 10.3 ± 2.96) min as compared to 14–37 (mean ± SD: 26.9 ± 8.39) min with pull-method PEG. The postoperative hospital day of E-PEG was within two days except for the two complicated cases. Significance differences of operation time, complication rate and postoperative hospital stay between those groups observed statistically.

Conclusions

These results indicate that E-PEG was safe, tolerable and speedy when compared ordinary pull-method PEG.

Ahmad I, Mouncher A, Abdoolah A, Stenson R, Wright J, Daniels A, Tillett J, Hawthorne AB, Thomas G (2003) Antibiotics prophylaxis for percutaneous endoscopic gastrostomy—a prospective, randomized, double-blind trial. Aliment Pharmacol Ther 18(2): 209–215PubMedCrossRef

Akkersdijk WL, van Bergeijk JD, van Egmond T, Mulder CJ, van Berge Henegouwen GP, van der Werken C, van Erpecum KJ (1995) Percutaneous endoscopic gastrostomy (PEG): comparison of push and pull methods and evaluation of antibiotic prophylaxis. Endoscopy 27(4): 313–316PubMed

Boswell WC, Boyd CR, Lord SA (1996) Percutaneous endoscopic gastrostomy with T-bar fixation in children. Surg Laparosc Endosc 6(4): 262–265PubMedCrossRef

Cosentini EP, Sautner T, Gnant M, Winkelbauer F, Teleky B, Jakesz R (1998) Outcomes of surgical, percutaneous endoscopic, and percutaneous radiologic gastrostomies. Arch Surg 133(10): 1076–1083PubMedCrossRef

Deitel M, Bendago M, Spratt EH, Burul CJ, To TB (1988) Percutaneous endoscopic gastrostomy by the “pull” and “introducer” methods. Can J Surg 31: 102–104PubMed

Dormann AJ, Huchzermeyer H (2002) Endoscopic techniques for enteral nutrition: standards and innovations. Dig Dis 20(2): 1451–1453CrossRef

Gauderer MW, Ponsky JL, Izant RJ Jr (1980) Gastrostomy without laparostomy: a percutaneous endoscopic technique. J Pediatr Surg 15(6): 872–875PubMedCrossRef

Gencosmanoglu R, Koc D, Tozun N (2003) Percutaneous endoscopic gastrostomy: results of 115 cases. Hepatogastroenterology 50(51): 886–888PubMed

Kanie J, Kono K, Kono T, Osawa M, Yamamoto T, Akatsu H, Shimokata H, Iguhi A (2000) Complications of percutaneous endoscopic gastrostomy in the elderly: local skin infection and respiratory infection. Nippon Ronen Igakkai Zasshi 37(2): 143–148PubMed

10.

Maetani I, Tada T, Ukita T, Inoue H, Sakaki Y, Yoshikawa M (2003) PEG with introducer or pull method: a prospective randomized comparison. Gastrointest Endosc 57(7): 837–841PubMedCrossRef

11.

Rimon E (2001) The safety and feasibility of percutaneous endoscopic gastrostomy placement by a single physician. Endoscopy 33(3): 241–244PubMedCrossRef

12.

Roche V (2003) Percutaneous endoscopic gastrostomy. Clinical care of PEG tubes in older adults. Geriatrics 58(11): 22–26, 28–29

13.

Russell TR, Brotman M, Norris F (1984) Percutaneous gastrostomy: A new simplified and cost-effective technique. Am J Surg 148: 132–137PubMedCrossRef

14.

Sartori S, Trevisani L, Nielsen I, Tassinari D, Abbasciano V (1996) Percutaneous endoscopic gastrostomy placement using the pull-through or push-through techniques: Is the second pass of the gastroscope necessary? Endoscopy 28(8): 686–688PubMedCrossRef

15.

Sheehan JJ, Hill AD, Fanning NP, Healy C, McDermott EW, O’Donoghue DP, O’Higgins NJ (2003) Percutaneous endoscopic gastrostomy: 5 years of clinical experience on 238 patients. Ir Med J 96(9): 256–257

16.

Steffes C, Weaver DW, Bouwman DL (1989) Percutaneous endoscopic gastrostomy. New technique-old complications. Am Surg 55(5): 273–277PubMed

17.

van der Merwe WG, Brown RA, Ireland JD, Goddard E (2003) Percutaneous endoscopic gastrostomy in children-a 5-year experience. S Afr Med J 93(10): 781–785PubMed

Title: Successful new method of extracorporeal percutaneous endoscopic gastrostomy (E-PEG)
Authors: Yoichi Toyama
Teruyuki Usuba
Kyonsu Son
Seiya Yoshida
Ryou Miyake
Ryusuke Ito
Kazuto Tsuboi
Hideyuki Kashiwagi
Hisao Tajiri
Katsuhiko Yanaga
Publication date: 01-11-2007
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 11/2007
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-007-9270-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Successful new method of extracorporeal percutaneous endoscopic gastrostomy (E-PEG)

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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