Outcomes and Complications of Radiological Gastrostomy vs. Percutaneous Endoscopic Gastrostomy for Enteral Feeding: An Updated Systematic Review and Meta-Analysis.

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY

Gastroenterology Research Pub Date : 2023-04-01 DOI:10.14740/gr1593

Zohaib Ahmed, Umair Iqbal, Muhammad Aziz, Syeda Faiza Arif, Joyce Badal, Umer Farooq, Wade Lee-Smith, Manesh Kumar Gangwani, Faisal Kamal, Abdallah Kobeissy, Asif Mahmood, Ali Nawras, Harshit S Khara, Bradley D Confer, Douglas G Adler

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引用次数: 1

Abstract

Background: Percutaneous endoscopic gastrostomy (PEG) and percutaneous radiological gastrostomy (PRG) are commonly utilized to establish access to enteral nutrition. However, data comparing the outcomes of PEG vs. PRG are conflicting. Therefore, we aimed to conduct an updated systemic review and meta-analysis comparing PRG and PEG outcomes.

Methods: Medline, Embase, and Cochrane library databases were searched until February 24, 2023. Primary outcomes included 30-day mortality, tube leakage, tube dislodgement, perforation, and peritonitis. Secondary outcomes included bleeding, infectious complications, and aspiration pneumonia. All analyses were conducted using Comprehensive Meta-Analysis Software.

Results: The initial search revealed 872 studies. Of these, 43 of these studies met our inclusion criteria and were included in the final meta-analysis. Of 471,208 total patients, 194,399 received PRG and 276,809 received PEG. PRG was associated with higher odds of 30-day mortality when compared to PEG (odds ratio (OR): 1.205, 95% confidence interval (CI): 1.015 - 1.430, I² = 55%). In addition, tube leakage and tube dislodgement were higher in the PRG group than in PEG (OR: 2.231, 95% CI: 1.184 - 4.2 and OR: 2.602, 95% CI: 1.911 - 3.541, respectively). Perforation, peritonitis, bleeding, and infectious complications were higher with PRG than PEG.

Conclusion: PEG is associated with lower 30-day mortality, tube leakage, and tube dislodgement rates than PRG.

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放射胃造口术与经皮内镜胃造口术进行肠内喂养的结果和并发症:最新的系统回顾和荟萃分析。

背景:经皮内镜胃造口术(PEG)和经皮放射胃造口术(PRG)通常用于建立肠内营养通路。然而，比较PEG和PRG结果的数据是相互矛盾的。因此，我们的目的是进行一项更新的系统评价和荟萃分析，比较PRG和PEG的结果。方法:检索截至2023年2月24日的Medline、Embase和Cochrane图书馆数据库。主要结局包括30天死亡率、管漏、管移位、穿孔和腹膜炎。次要结局包括出血、感染性并发症和吸入性肺炎。所有分析均采用综合meta分析软件进行。结果:最初的搜索显示了872项研究。其中，43项研究符合我们的纳入标准，并被纳入最终的荟萃分析。在471,208例患者中，194,399例接受PRG治疗，276,809例接受PEG治疗。与PEG相比，PRG与更高的30天死亡率相关(优势比(OR): 1.205, 95%可信区间(CI): 1.015 - 1.430, I2 = 55%)。此外，PRG组的管漏和管移位发生率高于PEG组(OR: 2.231, 95% CI: 1.184 - 4.2; OR: 2.602, 95% CI: 1.911 - 3.541)。PRG组穿孔、腹膜炎、出血和感染性并发症发生率高于PEG组。结论:与PRG相比，PEG的30天死亡率、管漏和管移位率较低。

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Gastroenterology Research GASTROENTEROLOGY & HEPATOLOGY-

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