Percutaneous Gastrostomies: Associated Complications in PUSH vs. PULL Techniques over 12 Years in a Referral Centre
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Published:2024-03-22
Issue:7
Volume:13
Page:1836
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ISSN:2077-0383
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Container-title:Journal of Clinical Medicine
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language:en
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Short-container-title:JCM
Author:
Piñar-Gutiérrez Ana1ORCID, González-Gracia Lucía1, Vázquez Gutiérrez Rocío1, García-Rey Silvia1, Jiménez-Sánchez Andrés1, González-Navarro Irene1, Tatay-Domínguez Dolores1, Garrancho-Domínguez Pilar1, Remón-Ruiz Pablo J.1ORCID, Martínez-Ortega Antonio J.1ORCID, Serrano-Aguayo Pilar1, Giménez-Andreu María Dolores1, García-Fernández Francisco José2, Bozada-García Juan Manuel2, Nacarino-Mejías Verónica3, López-Iglesias Álvaro3, Pereira-Cunill José Luis1ORCID, García-Luna Pedro Pablo1ORCID
Affiliation:
1. UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocio, 41013 Sevilla, Spain 2. Unidad de Aparato Digestivo, Hospital Universitario Virgen del Rocio, 41013 Sevilla, Spain 3. Unidad de Radiodiagnóstico, Hospital Universitario Virgen del Rocio, 41013 Sevilla, Spain
Abstract
Objectives: To compare complications associated with percutaneous gastrostomies performed using PUSH and PULL techniques, whether endoscopic (PEG) or radiological (PRG), in a tertiary-level hospital. Methods: This was a prospective observational study. Adult patients who underwent percutaneous PULL or PUSH gastrostomy using PEG or PRG techniques at the Virgen del Rocio University Hospital and subsequently followed up in the Nutrition Unit between 2009–2020 were included. X2 tests or Fisher’s test were used for the comparison of proportions when necessary. Univariate analysis was conducted to study risk factors for PRG-associated complications. Results: n = 423 (PULL = 181; PUSH = 242). The PULL technique was associated with a higher percentage of total complications (37.6% vs. 23.8%; p = 0.005), exudate (18.2% vs. 11.2%; p = 0.039), and irritation (3.3% vs. 0%; p = 0.006). In the total sample, there were 5 (1.1%) cases of peritonitis, 3 (0.7%) gastrocolic fistulas, and 1 (0.2%) death due to complications associated with gastrostomy. Gender, age, and different indications were not risk factors for a higher number of complications. The most common indications were neurological diseases (35.9%), head and neck cancer (29%), and amyotrophic lateral sclerosis (17.2%). Conclusions: The PULL technique was associated with more total complications than the PUSH technique, but both were shown to be safe techniques, as the majority of complications were minor.
Reference30 articles.
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