New "introducer" PEG-gastropexy with T fasteners: a pilot study

Enteral feeding is indicated for patients unable to maintain appropriate oral intake, and percutaneous endoscopic gastrostomy (PEG) is the most adequate long-term enteral access. Peristomal infections are the most common complications of PEG, occurring in up to 8% of patients, despite the use of pro...

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Bibliographic Details
Published in:Arquivos de gastroenterologia 2011-12, Vol.48 (4), p.231-235
Main Authors: Martins, Fernanda Prata, Sousa, Maris Celia Batista de, Ferrari, Angelo Paulo
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Antibiotic Prophylaxis
Enteral Nutrition - methods
Female
GASTROENTEROLOGY & HEPATOLOGY
Gastropexy - instrumentation
Gastrostomia, efeitos adversos
Gastrostomia, métodos
Gastrostomy - adverse effects
Gastrostomy - instrumentation
Gastrostomy - methods
Humans
Male
Middle Aged
Nutrição enteral
Pilot Projects
Surgical Wound Infection - prevention & control
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Summary:Enteral feeding is indicated for patients unable to maintain appropriate oral intake, and percutaneous endoscopic gastrostomy (PEG) is the most adequate long-term enteral access. Peristomal infections are the most common complications of PEG, occurring in up to 8% of patients, despite the use of prophylactic antibiotics. The "introducer" PEG-gastropexy technique avoids PEG tube passage through the oral cavity, preventing microorganisms' dislodgment to the peristomal site. To compare the incidence of peristomal wound infection at 7-day post-procedure after conventional "pull" technique versus a new "introducer" PEG-gastropexy kit. Secondary outcomes included success rates, procedure time, and other complications. Eighteen patients referred for PEG placement between June and December 2010 were randomly assigned to "pull" PEG with antibiotics or "introducer" PEG-gastropexy technique without antibiotics. Overall success rate for both methods was 100%, although mean procedure duration was higher in the "introducer" PEG-gastropexy group (12.6 versus 6.4 minutes, P = 0.0166). Infection scores were slightly higher in patients who underwent "pull" PEG with antibiotics compared with "introducer" PEG-gastropexy without antibiotics (1.33 ± 0.83 versus 0.75 ± 0.67, P = 0.29). Although procedure duration was longer in the "introducer" PEG-gastropexy, infection scores were marginally higher in the "pull" PEG technique.
ISSN:0004-2803
1678-4219
1678-4219
0004-2803
DOI:10.1590/s0004-28032011000400003