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Evaluation of percutaneous gastrostomy as a technique for permanent gastropexy
M J Waschak1, J T Payne, E R Pope
1Department of Small Animal Medicine and Surgery, University of Missouri-Columbia Veterinary Medical Teaching Hospital, USA.
Objective:
This study was designed to evaluate right-sided percutaneous endoscopic gastrostomy (PEG) as a method for creation of a permanent gastropexy.
Study Design:
Percutaneous endoscopic gastrostomy adhesions were evaluated by gross examination and by mechanical testing and the results were compared with those obtained by conventional incisional gastropexy.
Animals Or Sample Population:
Fourteen mixed-breed dogs.
Methods:
Incisional gastropexies were performed on the dogs of group one (N = 7) and PEG tubes were placed in the dogs of group 2 (N = 7). All skin sutures (group 1) and PEG tubes (group 2) were removed on day 14. The animals were maintained for an additional 44 days before euthanasia and immediate necropsy. Gastropexy adhesions were evaluated and collected for biomechanical evaluation using a materials testing machine.
Results:
The duration of the procedure for group 2 was less (32.86 min +/- 7.65) than for group 1 (56.29 min +/- 8.28). The number of complications was not significantly different between group 1 and group 2 (P = .103). Gastroperitoneal adhesions were present in 7 of 7 dogs in group 1 and 4 of 7 dogs in group 2. The adhesion lengths and widths were significantly lager in dogs in group 1 compared with those in group 2. The adhesions present in group 1 dogs sustained significantly greater tensile loads to failure (61.98 +/- 14.65 N), compared with the adhesions present in group 2 dogs (22.31 +/- 26.87 N).
Conclusions:
Right-sided PEG inconsistently formed a weak gastropexy and the procedure was associated with a trend toward greater morbidity than incisional gastropexy.
Clinical Relevance:
Right-sided PEG is not recommended as a means of prophylactic gastropexy.