Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"title":"Differentiation of \"Polyp\" and \"Pseudo Polyp\" in Gallbladder Polyps, Single-center Experience.","authors":"Deniz Tazeoglu, Ahmet Cem Esmer","doi":"10.1097/SLE.0000000000001363","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001363","url":null,"abstract":"<p><strong>Objective: </strong>The prevalence of gallbladder polyps is 0.3% to 9.5%. Gallbladder polyps are divided into polyps and pseudo polyps. We aim to determine the rate of polyps after histopathologic examination in patients who were operated on for gallbladder polyps and to choose the factors affecting the diagnosis of polyps.</p><p><strong>Patients and methods: </strong>Patients who underwent cholecystectomy between January 2012 and January 2022 were analyzed retrospectively. Demographic data of the patients, anthropometric measurements, preoperative radiologic imaging methods, characteristics (size and number of polyps), and histopathologic results of the gallbladder after cholecystectomy were recorded. After histopathologic examination, the patients were grouped as gallbladder polyp and pseudo polyp and compared.</p><p><strong>Result: </strong>A total of 162 (4.7%) patients were included in the study. 109 (67.3%) of the patients were in the polyp group, and 53 (32.7%) were in the pseudo polyp group. Polyp size and number were larger in the polyp group than in the pseudo polyp group and were odd in number (P = 0.03, P < 0.001). The radiologic polyp size cut-off value to identify the polyp was >8 mm (sensitivity: 84.2%, specificity: 66.0%).</p><p><strong>Conclusion: </strong>Gallbladder polyps are a common pathology. The distinction between true and pseudo polyp is critical. Therefore, it is essential to distinguish between polyps and pseudo polyps for cholecystectomy.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Large Thyroid Nodules (≥4 cm) on Surgical Outcomes Following Endoscopic Thyroidectomy Through the Bilateral Axillo-Breast Approach.","authors":"Lung-Yun Kang, Yu-Chia Chen, Tsung-Jung Liang","doi":"10.1097/SLE.0000000000001352","DOIUrl":"10.1097/SLE.0000000000001352","url":null,"abstract":"<p><strong>Objective: </strong>Endoscopic thyroidectomy through the bilateral axillo-breast approach (BABA) is predominantly used in cases involving low-risk thyroid malignancies and benign nodules measuring <4 cm. However, the efficacy and safety of this technique in larger goiters remain underexplored.</p><p><strong>Methods: </strong>This retrospective study compared perioperative data and pathologic outcomes among patients who underwent endoscopic BABA thyroidectomy categorized on the basis of the size of the dominant nodule (<4 vs ≥4 cm).</p><p><strong>Results: </strong>Among the 113 included patients, 81 (72%) had a dominant nodule measuring <4 cm (group 1) and 32 (28%) presented with a nodule measuring ≥4 cm (group 2). Group 2 experienced longer operative times, greater blood loss, and higher drainage volumes than group 1. However, pain scores and length of postoperative hospital stay were similar between the groups. None of the patients required conversion to open surgery. The incidence rates of vocal cord palsy and hypoparathyroidism did not differ significantly between groups. In group 2, three patients developed seroma (9%) and one exhibited delayed bleeding (3%). Pathologic examination revealed that 6 patients (19%) in group 2 had malignant neoplasms; 3 were identified in the dominant nodule, whereas the remaining 3 were identified in separate, smaller nodules. Throughout the mean follow-up period of 43 months, no recurrence or metastasis was reported.</p><p><strong>Conclusions: </strong>Endoscopic BABA thyroidectomy is a viable option for patients with large thyroid nodules (≥4 cm); however, this technique requires careful execution.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Different Endoscopic Treatment Methods on Bleeding Complications in Pedunculated Colorectal Polyps.","authors":"Xuan Li, Liang Bu, Xin Ye, Qing Han, Xi Yang, Lei Chen, Mingliang Yuan","doi":"10.1097/SLE.0000000000001362","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001362","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic resection of colorectal polyps offers several advantages, including ease of performance, reduced surgical time, and preservation of anatomic structures. However, bleeding remains a common complication of the endoscopic treatment of colorectal polyps, particularly with a higher incidence of postprocedural bleeding in pedunculated colorectal polyps. Currently, there is no optimal method for the resection of pedunculated colorectal polyps. The aim of this study was to compare the postresection bleeding outcomes of 3 different techniques for the removal of pedunculated colorectal polyps.</p><p><strong>Methods: </strong>A retrospective analysis of postresection bleeding following the use of 3 techniques-endoscopic mucosal resection, endoscopic submucosal dissection (ESD), and prophylactic clips was conducted on pedunculated colorectal polyps.</p><p><strong>Results: </strong>The incidence of delayed hemorrhage after endoscopic mucosal resection resection of pedunculated colorectal polyps was highest (18.9%). In contrast, the incidence rates of delayed bleeding in the ESD and prophylactic clip groups were 4.3% and 5.9%, respectively (P<0.05). The intraoperative bleeding rate was highest in the ESD group (6.5%), while no intraoperative bleeding occurred in the other 2 groups, indicating a statistically significant difference among the 3 groups (P<0.05). However, the need for endoscopic hemostasis due to delayed bleeding was not significantly different among the groups (P>0.05).</p><p><strong>Conclusion: </strong>Employing endoscopic submucosal dissection (ESD) and clamping the stalk of pedunculated polyps before removal can effectively reduce the risk of postpolypectomy bleeding. Furthermore, ESD offers distinct advantages for the removal of larger polyps, both at the stalk and the head.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choice of Anesthetic for Laparoscopic Bariatric Surgery Can Reduce the Use of Rescue Antiemetics in Postanesthesia Recovery Room: A Retrospective Observational Study.","authors":"Juraj Sprung, David O Warner, Omar M Ghanem, Lauren Y Lu, Marita Salame, Darrell R Schroeder, Toby N Weingarten","doi":"10.1097/SLE.0000000000001341","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001341","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative nausea and vomiting (PONV) is a frequent adverse event after bariatric surgery and is associated with patient dissatisfaction and increased health care burden. Aggressive multimodal antiemetic prophylaxis and the use of propofol infusion during anesthesia are associated with the reduction of PONV. In this study, we examined the use of rescue antiemetics following bariatric surgery performed with 3 different anesthetic strategies designed to reduce PONV: (1) primary volatile (VOL) anesthetic and propofol (PROP) infusion (VOL+PROP), (2) volatile anesthetic with propofol and dexmedetomidine (DEX) infusions (VOL+PROP+DEX), or (3) opioid-sparing total intravenous anesthesia (PROP+DEX).</p><p><strong>Methods: </strong>In this retrospective observational study, we included patients undergoing bariatric surgery from 2018-2022 who received 1 of 3 anesthetics: (1) VOL+PROP, (2) VOL+PROP+DEX, or (3) opioid-sparing PROP+DEX without a VOL. Inverse probability of treatment weighting analysis determined the association between the need for rescue-antiemetics in the postanesthesia care unit (PACU) and following PACU discharge.</p><p><strong>Results: </strong>Three hundred thirty-two patients received VOL+PROP, 354 VOL+PROP+DEX, and 166 PROP+DEX, and all received prophylactic antiemetics during surgery. After surgery, the PROP+DEX patients received fewer rescue antiemetics in the PACU compared with VOL+PROP (11% vs. 24%, P=0.002), and VOL+PROP+DEX fewer compared with VOL+PROP (16% vs. 24%, P=0.023). This differential antinausea effect was limited to PACU stay only. Rescue antiemetic use increased across all anesthetic management groups following PACU discharge until midnight on the day of surgery (ranging from 38% to 46% across groups, P=0.71) and through the first postoperative day (ranging from 47% to 57% across groups, P=0.20).</p><p><strong>Conclusions: </strong>The benefit associated with anesthetic strategies designed to reduce PONV was present but did not persist past PACU discharge. This finding suggests that aggressive perioperative multimodal antiemetic prophylaxis combined with anesthetic strategies designed to prevent PONV after bariatric surgery have only a short-lived effect, thus health care staff in hospital wards may expect to encounter high rates of PONV in these patients. There is a need for the development of novel antinausea treatments to reduce the rate of this frequent postoperative complication.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Intraoperative CO 2 Pneumoperitoneum Pressure in Gastrointestinal Surgery: A Systematic Review.","authors":"Roy Mahapatra, Matthew Fok, Nicola Manu, Maria Cameron, Aimee Johnson, Aaron Kler, Hayley Fowler, Rachael Clifford, Dale Vimalachandran","doi":"10.1097/SLE.0000000000001325","DOIUrl":"10.1097/SLE.0000000000001325","url":null,"abstract":"<p><strong>Introduction: </strong>Pneumoperitoneum is widely used in gastrointestinal surgery, particularly for laparoscopic or robotic procedures, with suggested advantages associated with low pressure. While existing data predominantly focuses on laparoscopic cholecystectomy, the assessment of intra-abdominal pressures in other gastrointestinal surgeries remains unexplored.</p><p><strong>Methods: </strong>This study conducted an electronic literature search for randomized control trials comparing low-pressure pneumoperitoneum to standard or high-pressure counterparts.</p><p><strong>Results: </strong>Out of 26 articles meeting inclusion criteria, encompassing 2077 patients, 15 demonstrated positive associations with low-pressure pneumoperitoneum. No significant difference in postoperative pain was found in the remaining papers. Methodological variations, diverse outcome reporting, and a prevalent high risk of bias precluded meta-analysis.</p><p><strong>Conclusions: </strong>The study highlights substantial outcome variability, urging cautious interpretation of aggregated results. Despite positive associations in specific cases, insufficient evidence was found to support the superiority of low-pressure pneumoperitoneum. The study recommends future research employing validated patient-reported outcome measures and standardized reporting to help guide the development of evidence-based guidelines and optimize patient care in abdominal surgeries.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Feasibility and Safety of Autologous Skin Flap-supported Loop Stomas.","authors":"Wei-Bin Li, Yi Zhang, Ruo-Chong He, Ji Li, Nan Kang, Jie An","doi":"10.1097/SLE.0000000000001360","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001360","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the benefits of utilizing autologous flap-supported loop stomas in comparison to conventional rod-supported loop stomas regarding feasibility, safety, convenience, and satisfaction among doctors and patients.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 98 patients who underwent ileostomy at the Gastrointestinal Department of Shanxi Bethune Hospital Affiliated to Shanxi Medical University from July 2017 to January 2021. On the basis of the ileostomy methods used, the patients were categorized into 2 groups: the autologous flap loop ileostomy group (intervention group, 48 cases) and the traditional loop ileostomy group (traditional group, 50 cases). The analysis focused on assessing the quality of the stoma, short-term and long-term complications associated with postoperative stoma, and differences in feasibility, safety, convenience, and economic factors between the 2 groups.</p><p><strong>Results: </strong>The intervention group exhibited lower rates of short-term postoperative complications compared with the traditional group, especially in peristomal dermatitis (P=0.002) and stoma leakage (P=0.001). In addition, the frequency of stoma appliance replacement and the average cost within a 2-week period were also superior to those of the traditional group (all P<0.001). Long-term complications were not significantly different between the 2 groups (P ≥ 0.05). Moreover, the intervention group had a shorter operating time (P=0.01) and less blood loss (P=0.006) than the traditional group for the ostomy closure surgery.</p><p><strong>Conclusions: </strong>Autologous flap-supported loop stoma shows a notable decrease in postoperative stoma-related short-term complications, offering superior feasibility, safety, convenience, with favorable economic aspects as well.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Weight Loss and Improvement in Metabolic Comorbidities Between Endoscopic Gastroplasty and Lifestyle Modifications: A Meta-analysis.","authors":"Kai Siang Chan, Sapphire Ho, Kathleen Pang, Aaryan Nath Koura, Aung Myint Oo, Saleem Ahmed, Danson Xue Wei Yeo, Charleen Yeo","doi":"10.1097/SLE.0000000000001361","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001361","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic gastroplasty (EG) is a less invasive method for managing obesity compared with bariatric surgery. However, evidence on the use of EG is still scarce. This study aims to review existing evidence comparing EG with lifestyle modifications (LM) in terms of weight loss and improvement in metabolic syndrome.</p><p><strong>Materials and methods: </strong>A systematic search was performed on PubMed, Embase, and the Cochrane Library from inception to August 2023. Exclusion criteria were patients who received concomitant pharmacological therapy for weight loss, the use of other endoscopic interventions apart from EG, and patients with prior bariatric surgery. Based on the heterogeneity of included studies, meta-analysis was performed using either a fixed-effect model or a random-effect model.</p><p><strong>Results: </strong>There were 5 studies (4 RCTs and 1 retrospective study) with 1007 patients included in the pooled analysis. Only a minority were males (n=199, 19.8%), and only 1 study included a Sham procedure in the LM group. Six-month percentage total body weight loss (%TBWL) (n=3 studies, MD: 6.34, 95% CI: 2.89, 9.78, P<0.01) and 12-month %TBWL (n=4 studies, MD: 6.43, 95% CI: 2.62, 10.25, P<0.01) were significantly higher in EG compared with LM. Patients in the EG group also had significant improvement in control of diabetes mellitus (n=2 studies, OR: 29.10, 95% CI: 5.84, 145.08) and hypertension (n=2 studies, OR: 2.35, 95% CI: 1.18, 4.70) compared with LM. Incidence of serious adverse events ranged from 2% to 5%.</p><p><strong>Conclusion: </strong>EG is effective for weight loss and improvement in metabolic comorbidities compared with LM alone but is suboptimal based on the Food and Drug Administration thresholds.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Ultrasound-guided Pancreatic Duct Drainage: A Systematic Review and Meta-analysis.","authors":"Ruixia Wang, Tong Su, Changqin Xu, Tong Xiao, Hongwei Xu, Xiuju Shi, Shulei Zhao","doi":"10.1097/SLE.0000000000001359","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001359","url":null,"abstract":"<p><strong>Background and objectives: </strong>Endoscopic ultrasound-guided pancreatic duct drainage (EUS-PD) has emerged as a minimally invasive therapeutic option for patients who cannot undergo traditional retrograde access to the pancreatic duct due to difficulties in cannulation or surgically altered anatomy. This meta-analysis aimed to evaluate the overall outcomes and safety of EUS-PD.</p><p><strong>Methods: </strong>We conducted a comprehensive search of major databases, including PubMed, EMBASE, Cochrane Library, and Science Citation Index, up until October 2023. The meta-analysis focused on technical and clinical success rates, as well as the overall adverse event (AE) rate.</p><p><strong>Results: </strong>A total of 27 trials involving 902 patients were included in the study. The cumulative rate of technical success is 89%, and the clinical success is 88%, whereas the AE rate was 17%. The most common AE observed was post-EUS-PD acute pancreatitis, with a rate of 3%. In addition, the cumulative rates of bleeding, perforation, pancreatic leak, and infection were 2%, 2%, 1%, and 1%, respectively.</p><p><strong>Conclusion: </strong>EUS-PD demonstrates highly favorable technical and clinical success rates, alongside acceptable AE rates, making it a highly effective procedure.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectus Sheath and Transversus Abdominis Plane Blocks for Preaponeurotic Endoscopic Repair: Is the Double Block the Solution for Postoperative Pain Management?","authors":"Antonio Toscano, Luca Domenico Bonomo, Paolo Capuano, Luca Cremascoli, Filippo Castelli, Mattia Puppo, Fabrizio Aprà, Alberto Jannaci, Salvatore Cuccomarino","doi":"10.1097/SLE.0000000000001358","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001358","url":null,"abstract":"<p><strong>Background: </strong>Diastasis recti abdominis (DRA) is a prevalent postpartum condition characterized by the separation of the rectus abdominis muscles with an interrectal distance >2.5 cm, often leading to symptoms like back pain, constipation, and urinary incontinence. Preaponeurotic endoscopic repair (REPA) is a novel, minimally invasive surgical approach for DRA, offering an alternative to traditional abdominoplasty. Despite its minimally invasive nature, REPA surgery poses significant postoperative pain challenges, typically managed with opioids, which carry numerous side effects.</p><p><strong>Materials and methods: </strong>This retrospective study evaluates the efficacy of combining 2 ultrasound-guided abdominal wall blocks, rectus sheath block (RSB) and transversus abdominis plane block (TAPB), to manage postoperative pain in 55 DRA patients who underwent REPA surgery. We performed lateral TAPB in 28 cases, whereas 27 received an association of TAPB and RSB.</p><p><strong>Results: </strong>At 6 hours postsurgery, 61% of patients in the TAPB group reported significant pain (Numeric Rating Scale >3), compared with 19% in the TAPB-RSB group (P = 0.001). The TAPB-RSB group also required fewer analgesic rescue doses (P = 0.042) and showed earlier recovery, with faster initiation of oral intake and mobility.</p><p><strong>Conclusion: </strong>The combination of TAPB and RSB significantly reduces opioid consumption, postoperative pain, and the need for rescue analgesia compared with TAPB alone. The dual-block approach, providing a multi-dermatomal sensory block, suggests a promising strategy for improving postoperative pain management in REPA surgery.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Predicting Major Complications and Mortality in Percutaneous Endoscopic Gastrostomy: 8 Years of Experience of a Tertiary Surgery Center.","authors":"Murat Yildirim, Asim Kocabay, Bulent Koca, Ali Ihsan Saglam, Namik Ozkan","doi":"10.1097/SLE.0000000000001342","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001342","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous endoscopic gastrostomy (PEG) is a safe method of choice for patients who need long-term nutritional support. However, complications and high mortality rates have been reported. Based on 8 years of experience in tertiary care hospitals, we aimed to identify risk factors associated with major complications and 30-day mortality after PEG.</p><p><strong>Methods: </strong>Patients who underwent PEG in the General Surgery clinic of Tokat Gaziosmanpaşa University, Faculty of Medicine between January 2014 and March 2022 were included in the study. Data regarding patient demographics, comorbidities, laboratory data, drugs used together, and indications for PEG tube placement were collected.</p><p><strong>Results: </strong>There were 429 patients. The mean age of the patients was 66.9±16.75 years, and 180 (44%) patients were female. The mean follow-up period was 8.84±6.75 months. Twenty patients (4.9%) had major complications. Female sex [Odds Ratio (OR) 0.33, 95% CI, CI=1.23-8.87, P=0.02] and diabetes mellitus (DM) (OR=0.23, 95% CI=1.93-6, P=0.002) were the independent variables associated with major complications. The all-cause 30-day mortality rate was 5.9% (n=24). Malignancy, DM, corticosteroid use, low albumin, and platelet values were associated with increased mortality in multivariate analysis as indications for PEG.</p><p><strong>Conclusions: </strong>Female sex and patients with DM may potentially face major complications. The patients with cancer, diabetes, and corticosteroid use were associated with higher mortality. In addition, low serum albumin and platelet levels were an effective factor for survival in patients undergoing PEG, and this should be taken into account in decision-making.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}