Percutaneous radiologic gastrostomy versus percutaneous endoscopic gastrostomy for enteral feeding: A systematic review and meta-analysis

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition Pub Date : 2024-05-28 DOI:10.1002/jpen.2646

Matheus Coelho Meine, Isabela Ho Tusato, Nathalia Hoffmeister, Gilmara Coelho Meine MD, MSc

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引用次数: 0

Abstract

Background

Percutaneous radiological gastrostomy (PRG) and percutaneous endoscopic gastrostomy (PEG) are minimally invasive gastrostomy techniques for individuals requiring prolonged enteral feeding. Recent meta-analyses concerning their efficacy and safety mainly included retrospective studies and yielded conflicting results. This meta-analysis of randomized controlled trials (RCTs) aimed to compare efficacy, safety, and procedure time between PRG and PEG for enteral feeding.

Methods

MEDLINE, Embase, and the Cochrane Library were searched for eligible RCTs comparing PRG and PEG for enteral feeding through February 23, 2024. The primary outcome was technical success. The secondary outcomes were (1) adverse events (AEs), (2) mortality, and (3) procedure time. We used the random-effects model to calculate pooled risk ratio (RR) and mean difference (MD) with corresponding 95% CIs for dichotomous and continuous outcomes, respectively.

Results

Five RCTs with 544 patients (268 PRG and 276 PEG) were included. There was similar technical success (RR = 1.02; 95% CI = 0.98–1.05; I² = 35%; moderate certainty of evidence because of inconsistency), overall mortality (RR = 1.25; 95% CI = 0.63–2.47; I² = 47%; very low certainty of evidence because of inconsistency, indirectness, and imprecision), and overall AEs risk (RR = 1.06; 95% CI = 0.63–1.76; I² = 81%; low certainty of evidence because of inconsistency and imprecision) between the two groups. However, compared with PEG, the procedure time was longer in the PRG group (MD = 19.35 min; 95% CI = 0.95–37.75 min; I² = 98%; very low certainty of evidence because of inconsistency and imprecision).

Conclusion

PRG and PEG demonstrate similar efficacy and safety; however, the endoscopic technique may boast a shorter procedure time.

查看原文本刊更多论文

经皮放射胃造瘘术与经皮内镜胃造瘘术用于肠道喂养：系统回顾和荟萃分析。

背景：经皮放射胃造口术（PRG）和经皮内镜胃造口术（PEG）是一种微创胃造口技术，适用于需要长期肠道喂养的患者。最近有关其疗效和安全性的荟萃分析主要包括回顾性研究，得出的结果相互矛盾。这项随机对照试验 (RCT) 的荟萃分析旨在比较 PRG 和 PEG 用于肠道喂养的疗效、安全性和手术时间：方法：检索了 MEDLINE、Embase 和 Cochrane 图书馆中截至 2024 年 2 月 23 日符合条件的 RCT，比较了 PRG 和 PEG 在肠道喂养中的应用。主要结果是技术成功率。次要结果为 (1)不良事件 (AE)、(2) 死亡率和 (3) 手术时间。我们使用随机效应模型计算了二分法和连续法结果的汇总风险比（RR）和平均差（MD），以及相应的 95% CI：共纳入了 5 项研究，544 例患者（268 例 PRG 和 276 例 PEG）。技术成功率（RR = 1.02；95% CI = 0.98-1.05；I² = 35%；由于不一致，证据的确定性为中等）、总死亡率（RR = 1.25；95% CI = 0.63-2.47；I² = 47%；由于不一致，证据的确定性为中等）均相似。47；I² = 47%；由于不一致、间接性和不精确性，证据确定性极低），以及两组间总体 AEs 风险（RR = 1.06；95% CI = 0.63-1.76；I² = 81%；由于不一致和不精确性，证据确定性低）。然而，与 PEG 相比，PRG 组的手术时间更长（MD = 19.35 分钟；95% CI = 0.95-37.75 分钟；I² = 98%；由于不一致和不精确，证据确定性很低）：结论：PRG 和 PEG 的疗效和安全性相似，但内窥镜技术的手术时间更短。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Parenteral and Enteral Nutrition 医学-营养学

CiteScore

7.80

自引率

8.80%

发文量

161

审稿时长

6-12 weeks

期刊介绍： The Journal of Parenteral and Enteral Nutrition (JPEN) is the premier scientific journal of nutrition and metabolic support. It publishes original peer-reviewed studies that define the cutting edge of basic and clinical research in the field. It explores the science of optimizing the care of patients receiving enteral or IV therapies. Also included: reviews, techniques, brief reports, case reports, and abstracts.