Feeding gastrostomy: surgical or endoscopic ? a prospective study

ABSTRACT

This study compared operative gastrostomy [OG] [performed by surgeons] with percutaneous endoscopic gastrostomy [PEG] [performed by physician endoscopists] in a prospective randomized fashion to determine whether one technique was superior. PEG [Sachs-Vine] and OG [Stamm] were done using local anesthesia. Patients were assessed for complications, mortality, tube Junction, and cost Groups were equally matched for indications and underlying disease. Fifty-seven had OG and 64 had attempted PEG. Complications occurred in 26% of OG patients and 9% died. Complications occurred in 25% of PEG patients and 12% died. Tube feeding was initiated in both groups within a mean of 29 [24 to 72] hours of the gastrostomy placement OG costed 1675 and PEG 979 local currency units to perform. We conclude that, there is no difference between OG [using local, anesthesia] and PEG with regard to morbidity, mortality, or tube Junction. The endoscopic technique does appear to have economic advantage