Evaluation of percutaneous gastrostomy as a technique for permanent gastropexy.

OBJECTIVE

This study was designed to evaluate right-sided percutaneous endoscopic gastrostomy (PEG) as a method for creation of a permanent gastropexy.

STUDY DESIGN

Percutaneous endoscopic gastrostomy adhesions were evaluated by gross examination and by mechanical testing and the results were compared with those obtained by conventional incisional gastropexy.

ANIMALS OR SAMPLE POPULATION

Fourteen mixed-breed dogs.

METHODS

Incisional gastropexies were performed on the dogs of group one (N = 7) and PEG tubes were placed in the dogs of group 2 (N = 7). All skin sutures (group 1) and PEG tubes (group 2) were removed on day 14. The animals were maintained for an additional 44 days before euthanasia and immediate necropsy. Gastropexy adhesions were evaluated and collected for biomechanical evaluation using a materials testing machine.

RESULTS

The duration of the procedure for group 2 was less (32.86 min +/- 7.65) than for group 1 (56.29 min +/- 8.28). The number of complications was not significantly different between group 1 and group 2 (P = .103). Gastroperitoneal adhesions were present in 7 of 7 dogs in group 1 and 4 of 7 dogs in group 2. The adhesion lengths and widths were significantly lager in dogs in group 1 compared with those in group 2. The adhesions present in group 1 dogs sustained significantly greater tensile loads to failure (61.98 +/- 14.65 N), compared with the adhesions present in group 2 dogs (22.31 +/- 26.87 N).

CONCLUSIONS

Right-sided PEG inconsistently formed a weak gastropexy and the procedure was associated with a trend toward greater morbidity than incisional gastropexy.

CLINICAL RELEVANCE

Right-sided PEG is not recommended as a means of prophylactic gastropexy.