A new form of access for endo-organ surgery : The initial experience with percutaneous endoscopic gastrostomy

• Published in: Surgical endoscopy Vol. 13; no. 8; pp. 738 - 741
• Main Authors: TOMONAGA, T, HOUGHTON, S. G, SHIINO, Y, AWAD, Z. T, MARSH, R. E, FILIPI, C. J, HINDER, R. A, HUNTER, J, DALLEMAGNE, B, KATKHOUDA, N, KOZAREK, R, DEMEESTER, T. R, DEEIK, R
• Format: Journal Article
• Language: English
• Published: New York, NY Springer 01.08.1999
• Subjects: Adult; Aged; Biological and medical sciences; Endoscopes; Gastrostomy - instrumentation; Gastrostomy - methods; Humans; Intraoperative Complications; Medical sciences; Middle Aged; Postoperative Complications; Retrospective Studies; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Gastrostomy; Human; Endoscopic surgery; Questionnaire; Indication; Digestive diseases; Laparoscopic surgery; Evolution; Technique; Gastric disease; Intraluminal; Percutaneous route
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s004649901089

Intraluminal gastric surgery provides a new treatment option for various disease processes. This study assesses the safety of a new large-diameter percutaneous endoscopic gastrostomy (PEG) for intraluminal surgery. Investigators at six institutions were asked to complete a standard questionnaire to assess the difficulties associated with the assembly and introduction of the PEG, plus intraoperative and postoperative problems related to placement of the device. In terms of assembly; 1.9% of respondents reported difficulty obtaining complete vacuum of the balloon tip, and 3.8% had difficulty fitting the graduated dilator to the balloon-tipped cannula. Difficulties associated with introduction of the PEG included disengagement of the dilator from the balloon-tipped cannula (0%), extraction of the dilator-port assembly (0%), difficult PEG pullout (1.9%), abdominal wall bleeding (0%), and difficult PEG dilator separation (7.5%). Intraoperatively, 7.5% of respondents reported inadequate skin bolster fitting, 1.9% had CO(2) leakage into the peritoneal cavity, 0% had inadvertent PEG extraction, and 0% reported injury to the esophagus, colon, or small intestine. Postoperatively, there was a 9.4% rate of wound infection, a 1.9% rate of gastrocutaneous fistula, and a 1.9% rate of esophageal, colon, or small intestine injury. The large-diameter PEG is safe and effective for endo-organ surgery. Additional preventive measures for PEG site infection should be investigated.