Assessment of safety and feasibility of a new technical variant of gastropexy for percutaneous endoscopic gastrostomy: an experience with 435 cases
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2009-06-26
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Background: Percutaneous Endoscopic Gastrostomy (PEG) performed through the Introducer
Technique is associated with lower risk of surgical infection when compared to the Pull Technique.
Its use is less widespread as the fixation of the stomach to the abdominal wall is a stage of the
procedure that is difficult to be performed. We present a new technical variant of gastropexy which
is fast and easy to be performed. The aim of this study was to evaluate the safety and feasibility of
a new technical variant of gastropexy in patients submitted to gastrostomy performed through the
Introducer Technique.
Methods: All the patients submitted to PEG through the Introducer Technique were evaluated
using a new technical variant of gastropexy, which consists of two parallel stitches of trasfixation
sutures involving the abdominal wall and the gastric wall, performed with a long curved needle.
Prophylactic antibiotics were not used. Demographic aspects, initial diagnosis, indication, sedation
doses, morbidity and surgical mortality were all analyzed.
Results: Four hundred and thirty-five consecutive PEGs performed between June 2004 and May
2007 were studied. Nearly all the cases consisted of patients presenting malignant neoplasia, 79.5%
of which sited in the head and neck. The main indication of PEG was dysphagia, found in 346
patients (79.5%). There were 12 complications (2.8%) in 11 patients, from which only one patient
had peristomal infection (0.2%). There was one death related to the procedure.
Conclusion: Gastropexy with the technical variant described here is easy to be performed and
was feasible and safe in the present study. PEG performed by the Introducer Technique with this
type of gastropexy was associated with low rates of wound infection even without the use of
prophylactic antibiotics.
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CAMPOLI, Paulo M. O.; CARDOSO, Daniela M. M.; TURCHI, Marília D.; EJIMA, Flávio H.; MOTA, Orlando M. Assessment of safety and feasibility of a new technical variant of gastropexy for percutaneous endoscopic gastrostomy: an experience with 435 cases. BMC Gastroenterology, New York, v. 9, n. 48, 2009.