The Comparative Study Between Percutaneous Endoscopic Gastrostomy And Surgical Gastrostomy

Objective To investigate the safety and feasibility of percutaneous endoscopic gastrostomy(PEG),and evaluate the advantage over surgical gastrostomy(SG).Methods In this retrospective study,42 patients selected due to various reasons were divided into PEG group(18 cases)and SG group(22 cases).The parameters of two groups were compared,which included the procedure location,anesthesia, procedure time,starting time of tube feeding,length of hospital stay,procedure cost and postoperative complication rate.Results Procedure was completed successfully in all patients, no procedure-related mortality occurred in the two groups.PEG group was all performed under the local anesthesia in the endoscope suite.There were 15 cases of SG group performed under the general anesthesia and 7 cases under the epidural anesthesia in the operating room.The procedure time of PEG group and SG group was (27.55±7.83)min and (62.73±9.48)min,respectively(P<0.01).The starting time of tube feeding was (24.89±1.76)h and (32.43±5.60)h,respectively(P<0.01).The length of hospital stay was (25.60±13.35)d and (28.82±17.19)d,respectively(P>0.05). The procedure cost was (1441.10±164.89)$and (2115.00±710.37)$,respectively(P<0.01).There were 3 minor complications in PEG group,including one patient with peristomal infection,one patient pulmonary infection,and one patient buried bumper syndrome.There were 5 minor complications in SG group, including one patient with peristomal infection,one patient wound infection,one patient both peristomal infection and wound infection,and one patient tube removal.There was one major complication in SG group,which was upper gastrointestinal hemorrhage.The postoperative complication rate was 15.00% and 27.27%, respectively(P>0.05).There were no significant differences of length of hospital stay and postoperative complication rate between two groups(P>0.05),but the parameters of procedure time,starting time of tube feeding,procedure cost in PEG group were significantly less than those of SG group(P<0.01).Conclusions As compared with SG technique,PEG is a safe and feasible one,it can be performed under the local anesthesia in the endoscope suite and has shorter procedure time and starting time of tube feeding,less procedure cost.PEG can generally replace SG as the first choice for clinical practice.