title: Insertion, efficacy, and removal of a nonendoscopically removable percutaneous endoscopic gastrostomy (PEG) tube.
abstract: BACKGROUND
  Externally removable PEG tubes require an internal bumper that can collapse to a size that is small enough to allow for its removal through the abdominal wall by external traction. Adequate force must be maintained to avoid accidental dislodgement of the tube prior to its desired removal.
  
  
  METHODS
  A nonendoscopically removable PEG (Inverta-PEG, Ross Products Division, Abbott Laboratories, Columbus, OH, USA) was evaluated in a nonmasked, prospective clinical study involving 131 patients enrolled by 25 physicians. The over-the-wire (Sacks-Vine) technique was used for all placements. After insertion, patients were followed weekly for 8 weeks. During week 9, the PEGs were removed percutaneously (nonendoscopically). Insertion, efficacy, and removal performance were evaluated.
  
  
  RESULTS
  Complication rate during insertion was 1.5% and removal was 1.2%. Qualitatively, investigators rated ease of insertion and removal as very easy, easy, average, difficult, or very difficult. Investigators rated 98.5% of insertions as very easy, easy, or average; 95.4% of removals were rated as very easy, easy, or average. Some patients exited the study prematurely due to leakage around the stoma (2.3%) and inadvertent tube removal (5.3%). These complication rates were consistent with earlier reports of other PEG studies.
  
  
  CONCLUSIONS
  These results demonstrate that Inverta-PEG is a safe and effective tube that can be removed nonendoscopically with ease in 95% of the cases.
authors.affiliation: Department of Medicine, Hennepin County Medical Center GI Laboratory, 701 Park Avenue South, Minneapolis, MN 55415, USA.
authors.forename: O W
authors.initials: OW
authors.lastname: Cass
authors.forename: K
authors.initials: K
authors.lastname: Rowland
authors.forename: B
authors.initials: B
authors.lastname: Bartram
authors.forename: J R
authors.initials: JR
authors.lastname: Ross
authors.forename: Y
authors.initials: Y
authors.lastname: Choe
authors.forename: J D
authors.initials: JD
authors.lastname: Hall
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D005069:Evaluation Studies as Topic; D005260:Female; D020699:Gastroscopes; D005774:Gastrostomy / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011183:Postoperative Complications; D011446:Prospective Studies