A randomized trial comparing percutaneous endoscopic gastrostomy (PEG) and radiologically inserted percutaneous...

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Surgical Procedures

Background:

• Percutaneous endoscopic gastrostomy (PEG) is the standard for permanent feeding tubes in chronic severe dysphagia.
• This study is the first prospective randomized comparison of PEG and radiologically inserted gastrostomy (RIG) in adults.

Purpose of the Study:

• To compare the safety and efficacy of PEG versus RIG in adult patients requiring a feeding gastrostomy.
• To evaluate operative time, adverse events, mortality, and health status.

Main Methods:

• 106 adult patients eligible for both PEG and RIG were randomized.
• Data collected included operative time, adverse events at 10 and 30 days, 6-month mortality, and European Quality of Life 5 Dimensions (EQ-5D) scores.

Main Results:

• PEG had a significantly shorter median operative time (10 min vs. 20 min).
• PEG demonstrated a lower rate of adverse events (22% vs. 51%) and 30-day mortality (2% vs. 14%).
• Patient-reported health status remained low but showed improvement in the RIG group.

Conclusions:

• PEG is recommended as the primary procedure for feeding gastrostomy due to fewer tube complications.
• RIG is a valid alternative, and both techniques can complement each other.