New "introducer" PEG-gastropexy with T fasteners: a pilot study

Area of Science:

• Gastroenterology
• Surgical Innovation
• Infection Control

Background:

• Percutaneous endoscopic gastrostomy (PEG) is crucial for long-term enteral feeding when oral intake is insufficient.
• Peristomal infections are common PEG complications, occurring in up to 8% of patients, even with antibiotic prophylaxis.
• The introducer PEG-gastropexy technique bypasses oral passage, potentially reducing microbial dislodgment to the stoma site.

Purpose of the Study:

• To compare peristomal wound infection rates 7 days post-procedure between conventional "pull" PEG and the "introducer" PEG-gastropexy technique.
• To evaluate secondary outcomes including success rates, procedure duration, and other complications.

Main Methods:

• A randomized study involving 18 patients undergoing PEG placement.
• Patients were assigned to either the conventional "pull" PEG with antibiotics or the "introducer" PEG-gastropexy without antibiotics.

Main Results:

• Both techniques achieved a 100% success rate.
• The "introducer" PEG-gastropexy group had a significantly longer mean procedure duration (12.6 min vs. 6.4 min, P=0.0166).
• Infection scores were slightly higher in the "pull" PEG group (1.33 ± 0.83) compared to the "introducer" PEG-gastropexy group (0.75 ± 0.67), though not statistically significant (P=0.29).

Conclusions:

• The "introducer" PEG-gastropexy technique demonstrated a trend towards lower infection scores compared to the conventional "pull" PEG method.
• While the "introducer" technique resulted in a longer procedure time, it may offer benefits in reducing peristomal infections.