TY - JOUR
T1 - A new form of access for endo-organ surgery
T2 - The initial experience with percutaneous endoscopic gastrostomy
AU - Tomonaga, T.
AU - Houghton, S. G.
AU - Filipi, C. J.
AU - Hinder, R. A.
AU - Hunter, J.
AU - Dallemagne, B.
AU - Katkhouda, N.
AU - Kozarek, R.
AU - DeMeester, T. R.
AU - Deeik, R.
AU - Shiino, Y.
AU - Awad, Z. T.
AU - Marsh, R. E.
PY - 1999/8
Y1 - 1999/8
N2 - Background: 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. Methods: 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. Results: 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 CO2 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. Conclusions: The large-diameter PEG is safe and effective for endo-organ surgery. Additional preventive measures for PEG site infection should be investigated.
AB - Background: 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. Methods: 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. Results: 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 CO2 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. Conclusions: The large-diameter PEG is safe and effective for endo-organ surgery. Additional preventive measures for PEG site infection should be investigated.
KW - Endo-organ
KW - Gastric surgery
KW - Intraluminal surgery
KW - Operative port
KW - Percutaneous endoscopic gastrostomy
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U2 - 10.1007/s004649901089
DO - 10.1007/s004649901089
M3 - Article
C2 - 10430675
AN - SCOPUS:0032769527
SN - 0930-2794
VL - 13
SP - 738
EP - 741
JO - Surgical endoscopy
JF - Surgical endoscopy
IS - 8
ER -