Published online Sep 18, 2023. doi: 10.13105/wjma.v11.i6.277
Peer-review started: February 28, 2023
First decision: March 24, 2023
Revised: May 17, 2023
Accepted: June 16, 2023
Article in press: June 16, 2023
Published online: September 18, 2023
Gastrostomy feeding is superior to nasogastric tube feeding when medium to long-term enteral feeding (≥ 4 wk) is indicated. The optimal technique for long-term enteral feeding is not yet well established. Therefore, we performed a meta-analysis comparing the two methods.
This paper motivation is to demonstrate which technique for performing a gastrostomy has the lowest incidence rate of adverse events.
The aim of the paper is to compare the technique of endoscopic gastrostomy (PEG) and gastrostomy via interventional radiology (PRG) and establish which technique is the safest for the patient.
Comparative studies of PEG and PRG were selected. Included studies had outcomes such as infection, bleeding, pneumonia, pain, peritonitis and tube related complications. The risk of bias and quality of evidence were assessed. The analysis was performed using Review Manager (RevMan 5.4) from the Cochrane Informatics & Knowledge Management Department website.
Seventeen studies were included, with a total of 465218 patients. The only outcome that showed a significant difference was tube-related complications in retrospective studies favoring PEG (95%CI: 0.03 to 0.08; P < 0.00001), although this outcome did not show significant difference in randomized studies (95%CI: -0.07 to 0.04; P = 0.13). There was no difference in the analyses of the following outcomes: Infection in retrospective (95%CI: -0.01 to 0.00; P < 0.00001) or randomized (95%CI: -0.06 to 0.04; P = 0.44) studies; bleeding in retrospective (95%CI: -0.00 to 0.00; P < 0.00001) or randomized (95%CI: -0.06 to 0.02; P = 0.43) studies; pneumonia in retrospective (95%CI: -0.04 to 0.00; P = 0.28) or randomized (95%CI: -0.09 to 0.11; P = 0.39) studies; pain in retrospective (95%CI: -0.05 to 0.02; P < 0.00001) studies; peritonitis in retrospective (95%CI: -0.02 to 0.01; P < 0.0001) studies.
The study concluded that RIG has a higher incidence of tube-related complications than PEG. This difference is probably associated with the caliber of the tubes used. There was no statistical difference in the other outcomes evaluated.
This study aimed to determine which technique is safer for the patient, and both methods proved to be safe. We can conclude that the choice of technique depends on the type of patient, the experience of the service, the cost, and the availability of the method.