This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Sedlack, R. E. Articles by Baron, T. H. Search for Related Content PubMed PubMed Citation Articles by Sedlack, R. E. Articles by Baron, T. H. Social Bookmarking                         What's this?

Percutaneous Endoscopic Gastrostomy Placement Without Skin Incision: Results of a Randomized Trial

From the Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota

Correspondence: Todd Baron, MD, 200 1^st Street SW, Rochester, MN 55905. Electronic mail may be sent to baron.todd{at}mayo.edu.

Background: During percutaneous endoscopic gastrostomy (PEG) placement, skin incision is performed as standard practice. We suspected that this time-honored principle is unnecessary. Methods: In a prospective, randomized trial, 50 adults undergoing PEG placement were randomized to skin incision omission PEG (IOPEG) and standard PEG (SPEG). Two- and 7-day PEG site evaluations were performed to grade stomal infection, bleeding, pain, and overall satisfaction using a standardized scoring system. Median stomal evaluation scores were compared between groups using a Wilcoxon rank-sum test. Completion rates were compared using a t-test. Results: Placement success for the IOPEG and SPEG technique was 22/25 (88%) and 24/25 (96%), respectively (p = NS). Three failed IOPEG attempts required an incision to complete due to increased pull force encountered. One SPEG failed due to inability to transilluminate. Stomal evaluation scores of infection, bleeding, pain, leakage, and patient satisfaction were not significantly different at 2 or 7 days. No serious complications occurred as a result of skin incision omission. Conclusions: Omitting the skin incision does not significantly alter the placement success rate, patient satisfaction, or the rate of stomal complications, thus dispelling the dogma that a skin incision is mandatory for PEG placement and the myth that incisions reduce infectious complications.

Journal of Parenteral and Enteral Nutrition, Vol. 30, No. 3, 240-245 (2006)
DOI: 10.1177/0148607106030003240


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?