Survival analysis after gastrostomy: a single-centre, observational study comparing radiological and endoscopic...

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Surgical Outcomes

Background:

• Percutaneous endoscopic gastrostomy (PEG) is a common method for gastrostomy insertion.
• Per-oral image-guided gastrostomy (PIG) offers an alternative, potentially benefiting high-risk patients.
• Limited large-scale comparative studies exist for PEG versus PIG.

Purpose of the Study:

• To compare mortality rates between percutaneous endoscopic gastrostomy (PEG) and per-oral image-guided gastrostomy (PIG).
• To analyze short-term (30-day) and long-term (1-year) outcomes following gastrostomy insertion.
• To investigate outcomes in specific patient subgroups.

Main Methods:

• Prospective data collection of patients undergoing gastrostomy insertion.
• Analysis of demographic, biochemical, and outcome data from February 2004 to 2007.
• Subgroup analysis based on indications: cognitive impairment, dysphagic stroke, oropharyngeal cancer, neurological cancer, and others.

Main Results:

• 170 PIGs and 233 PEGs were inserted. No significant difference in 30-day mortality (15.3% for PIG vs. 10.7% for PEG, P=0.17) or 1-year mortality (54.1% for PIG vs. 56.7% for PEG, P=0.60).
• Higher 30-day mortality observed in nasopharyngeal cancer patients undergoing PIG (13.2%) compared to PEG (1.4%, P=0.005).
• PIG patients were older and had more comorbidities than PEG patients.

Conclusions:

• Overall, PIG and PEG demonstrate comparable 30-day and 1-year mortality rates.
• The choice between PIG and PEG can be guided by technical considerations and local resource availability.
• Further research may be warranted to explore specific subgroup outcomes.