PMID- 36247074
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221019
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 10
IP  - 8
DP  - 2022 Aug
TI  - Use of an electromagnetic-guided device to assist with post-pyloric placement of 
      a nasoenteral feeding tube: A systematic review and meta-analysis.
PG  - E1118-E1126
LID - 10.1055/a-1789-0491 [doi]
AB  - Background and study aims  While endoscopic-guided placement (EGP) of a 
      post-pyloric nasoenteral feeding tube may improve caloric intake and reduce the 
      risk of bronchoaspiration, an electromagnetic-guided placement (EMGP) method may 
      obviate the need for endoscopic procedures. Therefore, the primary aim of this 
      study was to perform a systematic review and meta-analysis of randomized trials 
      comparing the efficacy and safety of EMGP versus EGP of a post-pyloric feeding 
      tube. Methods  Protocolized searches were performed from the inception through 
      January 2021 following PRISMA guidelines. Only randomized controlled trials were 
      included comparing EMGP versus EGP. Study outcomes included: technical success 
      (defined as appropriate post-pyloric positioning), tube and patient associated 
      adverse events (AEs), time to enteral nutrition, procedure-associated cost, and 
      procedure time. Pooled risk difference (RD) and mean difference (MD) were 
      calculated using a fixed-effects model and heterogeneity evaluated using Higgins 
      test (I (2) ). Results  Four randomized trials (n = 536) were included. A total 
      of 287 patients were included in the EMGP group and 249 patients in the EGP 
      group. There was no difference between EMGP versus EGP regarding technical 
      success, tube-related AEs, patient-related AEs, procedure time, and time in the 
      right position. Time to enteral nutrition favored EMGP (MD: -134.37 [-162.13, 
      -106.61]; I (2)  = 35 %); with significantly decreased associated cost (MD: 
      -127.77 ($) [-135.8-119.73]; I (2)  = 0 %). Conclusions  Based on this study, 
      EMGP and EGP were associated with similar levels of technical success and safety 
      as well as time to complete the procedure. Despite this, EMGP was associated with 
      reduced cost and time to initiation of nutrition.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Mancini, Fabio Catache
AU  - Mancini FC
AD  - Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo 
      School of Medicine, Sao Paulo, Brazil.
FAU - de Moura, Diogo Turiani Hourneaux
AU  - de Moura DTH
AD  - Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo 
      School of Medicine, Sao Paulo, Brazil.
FAU - Funari, Mateus Pereira
AU  - Funari MP
AD  - Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo 
      School of Medicine, Sao Paulo, Brazil.
FAU - Ribeiro, Igor Braga
AU  - Ribeiro IB
AD  - Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo 
      School of Medicine, Sao Paulo, Brazil.
FAU - Neto, Fernando Lopes Ponte
AU  - Neto FLP
AD  - Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo 
      School of Medicine, Sao Paulo, Brazil.
FAU - Mendieta, Pastor Joaquin Ortiz
AU  - Mendieta PJO
AD  - Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo 
      School of Medicine, Sao Paulo, Brazil.
FAU - McCarty, Thomas R
AU  - McCarty TR
AD  - Division of Gastroenterology, Hepatology and Endoscopy - Brigham and Women's 
      Hospital - Harvard Medical School.
FAU - Bernardo, Wanderley Marques
AU  - Bernardo WM
AD  - Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo 
      School of Medicine, Sao Paulo, Brazil.
FAU - Nahas, Sergio Carlos
AU  - Nahas SC
AD  - Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo 
      School of Medicine, Sao Paulo, Brazil.
FAU - de Moura, Eduardo Guimaraes Hourneaux
AU  - de Moura EGH
AD  - Gastrointestinal Endoscopy Unit, Hospital das Clinicas, University of Sao Paulo 
      School of Medicine, Sao Paulo, Brazil.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220815
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC9558487
COIS- Competing interests Dr. Hourneaux de Moura is a consultant for Boston Scientific 
      and Olympus.
EDAT- 2022/10/18 06:00
MHDA- 2022/10/18 06:01
PMCR- 2022/08/01
CRDT- 2022/10/17 04:42
PHST- 2021/04/16 00:00 [received]
PHST- 2021/12/01 00:00 [accepted]
PHST- 2022/10/17 04:42 [entrez]
PHST- 2022/10/18 06:00 [pubmed]
PHST- 2022/10/18 06:01 [medline]
PHST- 2022/08/01 00:00 [pmc-release]
AID - 10.1055/a-1789-0491 [doi]
PST - epublish
SO  - Endosc Int Open. 2022 Aug 15;10(8):E1118-E1126. doi: 10.1055/a-1789-0491. 
      eCollection 2022 Aug.