PMID- 29340295
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220311
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 6
IP  - 1
DP  - 2018 Jan
TI  - Usage characteristics and adverse event rates ​of the direct puncture and pull 
      techniques for percutaneous endoscopic gastrostomy in patients with malignant 
      tumors of the upper aerodigestive tract.
PG  - E29-E35
LID - 10.1055/s-0043-121879 [doi]
AB  - BACKGROUND AND STUDY AIMS:  Patients with malignant tumors of the upper 
      gastrointestinal tract are at risk of weight loss. Early supportive nutrition 
      therapy is therefore recommended and usually requires placement of a percutaneous 
      endoscopic gastrostomy (PEG). The aim of this study was to compare adverse events 
      and usage characteristics of the direct puncture technique with those of the 
      traditional pull technique when used in patients with endoscopically passable 
      tumors. The primary endpoint was the rate of inflammatory adverse events (AEs) at 
      the gastrostomy fistula. The secondary endpoint was the long-term rate of 
      puncture-site metastases. PATIENTS AND METHODS:  One hundred twenty patients 
      (median age 56; IQR 36, 86 years) were randomized and treated per protocol in 
      this prospective open randomized single-center study. Follow-ups were conducted 
      on the third and seventh post-interventional days, after 1, 3 and 6 months and 
      the last follow-up 5 years after intervention. RESULTS:  Within the short-term 
      follow-up period of 6 months after PEG placement, AEs were noted in 47 patients 
      (39.2 %). These included 22 inflammations and 16 device dislocations and were 
      mainly found in the puncture group (33 vs. 14 in the pull group) with a 
      significantly increased incidence in the first month after PEG insertion ( P 
       = 0.001). Evaluation of the 5-year data did not reveal any significant 
      differences. The gastrostomy tube was used in 101 patients (84.2 %) (range 18 
      days to 5 years). CONCLUSIONS:  Our results favor the pull technique for patients 
      with endoscopically passable tumors of the upper gastrointestinal tract due to 
      less short-term adverse events. Both systems contributed equally to secure 
      long-term use.
FAU - Teich, Niels
AU  - Teich N
AD  - Klinikum St. Georg, Klinik fur Gastroenterologie und Hepatologie, Leipzig, 
      Germany.
AD  - Internistische Gemeinschaftspraxis fur Verdauungs- und Stoffwechselkrankheiten, 
      Leipzig, Germany.
AD  - Medizinische Fakultat der Friedrich-Schiller-Universitat Jena, Jena.
FAU - Selig, Lars
AU  - Selig L
AD  - Universitat Leipzig, Klinik und Poliklinik fur Gastroenterologie und 
      Rheumatologie, Leipzig, Germany.
FAU - Liese, Susanne
AU  - Liese S
AD  - Universitat Rostock, Klinik und Poliklinik fur Mund-, Kiefer- und Plastische 
      Gesichtschirurgie, Rostock, Germany.
FAU - Schiefke, Franziska
AU  - Schiefke F
AD  - Universitat Leipzig, Klinik fur Mund-, Kiefer- und Plastische Gesichtschirurgie, 
      Leipzig, Germany.
AD  - Gemeinschaftspraxis fur Mund-, Kiefer- und Gesichtschirurgie am Johannisplatz, 
      Leipzig, Germany.
FAU - Hemprich, Alexander
AU  - Hemprich A
AD  - Universitat Leipzig, Klinik fur Mund-, Kiefer- und Plastische Gesichtschirurgie, 
      Leipzig, Germany.
FAU - Mossner, Joachim
AU  - Mossner J
AD  - Universitat Leipzig, Klinik und Poliklinik fur Gastroenterologie und 
      Rheumatologie, Leipzig, Germany.
FAU - Schiefke, Ingolf
AU  - Schiefke I
AD  - Klinikum St. Georg, Klinik fur Gastroenterologie und Hepatologie, Leipzig, 
      Germany.
AD  - Gastroenterologie und Hepatologie am Johannisplatz, Leipzig, Germany.
LA  - eng
PT  - Journal Article
DEP - 20180112
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC5766340
COIS- Competing interests None
EDAT- 2018/01/18 06:00
MHDA- 2018/01/18 06:01
PMCR- 2018/01/01
CRDT- 2018/01/18 06:00
PHST- 2017/05/14 00:00 [received]
PHST- 2017/09/12 00:00 [accepted]
PHST- 2018/01/18 06:00 [entrez]
PHST- 2018/01/18 06:00 [pubmed]
PHST- 2018/01/18 06:01 [medline]
PHST- 2018/01/01 00:00 [pmc-release]
AID - 10.1055/s-0043-121879 [doi]
PST - ppublish
SO  - Endosc Int Open. 2018 Jan;6(1):E29-E35. doi: 10.1055/s-0043-121879. Epub 2018 Jan 
      12.