Ahmed Zohaib, Iqbal Umair, Aziz Muhammad, Arif Syeda Faiza, Badal Joyce, Farooq Umer, Lee-Smith Wade, Gangwani Manesh Kumar, Kamal Faisal, Kobeissy Abdallah, Mahmood Asif, Nawras Ali, Khara Harshit S, Confer Bradley D, Adler Douglas G
Department of Internal Medicine, University of Toledo, Toledo, OH, USA.
Zohaib Ahmed and Umair Iqbal contributed equally and shared the first authorship.
Gastroenterology Res. 2023 Apr;16(2):79-91. doi: 10.14740/gr1593. Epub 2023 Apr 28.
Percutaneous endoscopic gastrostomy (PEG) and percutaneous radiological gastrostomy (PRG) are commonly utilized to establish access to enteral nutrition. However, data comparing the outcomes of PEG vs. PRG are conflicting. Therefore, we aimed to conduct an updated systemic review and meta-analysis comparing PRG and PEG outcomes.
Medline, Embase, and Cochrane library databases were searched until February 24, 2023. Primary outcomes included 30-day mortality, tube leakage, tube dislodgement, perforation, and peritonitis. Secondary outcomes included bleeding, infectious complications, and aspiration pneumonia. All analyses were conducted using Comprehensive Meta-Analysis Software.
The initial search revealed 872 studies. Of these, 43 of these studies met our inclusion criteria and were included in the final meta-analysis. Of 471,208 total patients, 194,399 received PRG and 276,809 received PEG. PRG was associated with higher odds of 30-day mortality when compared to PEG (odds ratio (OR): 1.205, 95% confidence interval (CI): 1.015 - 1.430, I = 55%). In addition, tube leakage and tube dislodgement were higher in the PRG group than in PEG (OR: 2.231, 95% CI: 1.184 - 4.2 and OR: 2.602, 95% CI: 1.911 - 3.541, respectively). Perforation, peritonitis, bleeding, and infectious complications were higher with PRG than PEG.
PEG is associated with lower 30-day mortality, tube leakage, and tube dislodgement rates than PRG.
经皮内镜下胃造口术（PEG）和经皮放射学胃造口术（PRG）常用于建立肠内营养通路。然而，比较PEG和PRG结果的数据存在冲突。因此，我们旨在进行一项更新的系统评价和荟萃分析，比较PRG和PEG的结果。
检索Medline、Embase和Cochrane图书馆数据库，直至2023年2月24日。主要结局包括30天死亡率、导管渗漏、导管移位、穿孔和腹膜炎。次要结局包括出血、感染性并发症和吸入性肺炎。所有分析均使用综合荟萃分析软件进行。
初步检索共找到872项研究。其中，43项研究符合我们的纳入标准，并被纳入最终的荟萃分析。在总共471208例患者中，194399例接受了PRG，276809例接受了PEG。与PEG相比，PRG与30天死亡率较高相关（优势比（OR）：1.205，95%置信区间（CI）：1.015 - 1.430，I² = 55%）。此外，PRG组的导管渗漏和导管移位发生率高于PEG组（OR分别为：2.231，95% CI：1.184 - 4.2；OR：2.602，95% CI：1.911 - 3.541）。PRG组的穿孔、腹膜炎、出血和感染性并发症发生率高于PEG组。
与PRG相比，PEG的30天死亡率、导管渗漏和导管移位率较低。
