Kinzel Tobias Horst, Reich Viktoria, Schuhmacher Leonie, Bojarski Christian, Adler Andreas, Veltzke-Schlieker Wielfried, Jürgensen Christian, Tacke Frank, Siegmund Britta, Buchkremer Juliane, Branchi Federica, Treese Christoph
Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Endosc Int Open. 2025 Feb 26;13:a25112096. doi: 10.1055/a-2511-2096. eCollection 2025.
The direct puncture technique has been associated with a better safety profile compared with the classical pull-through technique for insertion of a percutaneous endoscopic gastrostomy (PEG). In this study, the safety of the hybrid PEG technique, combining gastropexy with the pull-through technique, was analyzed in a large retrospective patient cohort.
Clinical data from patients undergoing PEG insertion in a high-volume center for endoscopy were included retrospectively between January 2016 and December 2021. Patient characteristics and complication rates were correlated in univariate and multivariate analyses.
Data from 351 patients undergoing PEG insertion with the hybrid PEG technique were compared with 145 procedures with the direct puncture technique and 1073 procedures with the pull-through technique. In the group where gastropexy was performed (hybrid PEG and direct puncture), we could not find any significant differences in frequency of major and minor complications. Comparing the pull-through technique with the gastropexy group, we detected a five-fold higher major complication rate and a doubled minor complication rate for the pull-through technique. Multivariate analysis confirmed the protective role of gastropexy, with an odds ratio of 0.166 (0.084-0.329; < 0.001) for major complications.
Hybrid PEG and direct puncture are equally safe PEG insertion techniques, with significantly better safety profiles than the pull-through technique. Despite the retrospective design of the study, these results suggest preferential use of hybrid PEG due to handling.
与经皮内镜下胃造口术（PEG）插入的经典拖入技术相比，直接穿刺技术具有更好的安全性。在本研究中，对结合胃固定术与拖入技术的混合PEG技术在大量回顾性患者队列中的安全性进行了分析。
回顾性纳入2016年1月至2021年12月在一个大容量内镜中心接受PEG插入术的患者的临床资料。在单因素和多因素分析中，将患者特征与并发症发生率进行关联分析。
将351例采用混合PEG技术进行PEG插入术的患者的数据与145例采用直接穿刺技术和1073例采用拖入技术的手术数据进行比较。在进行胃固定术的组（混合PEG和直接穿刺）中，我们未发现主要和次要并发症发生率有任何显著差异。将拖入技术与胃固定术组进行比较，我们发现拖入技术的主要并发症发生率高出五倍，次要并发症发生率高出一倍。多因素分析证实了胃固定术的保护作用，主要并发症的比值比为0.166（0.084 - 0.329；<0.001）。
混合PEG和直接穿刺是同样安全的PEG插入技术，其安全性显著优于拖入技术。尽管本研究为回顾性设计，但这些结果表明，由于操作原因，优先使用混合PEG。
