title: An evaluation of the "cut and push" method of percutaneous endoscopic gastrostomy (PEG) removal.
abstract: BACKGROUND
  This study aimed to establish whether 15-Fr gauge percutaneous endoscopic gastrostomy (PEG) tubes can be safely removed by "cut and push."
  
  
  METHODS
  Patients were prospectively recruited who were found to be without significant intestinal dysfunction requiring removal of Freka (Fresenius Kabi) 15-Fr gauge PEG tubes. The PEG tube was cut close to the stoma and the remnant pushed into the gastric lumen with a 14-Fr nasogastric tube. Patients were asked to observe their stool for the remnant. Patients were contacted at day 7 and an abdominal x-ray was arranged for those who had not seen the remnant in the stool. If the remnant was still present as seen on plain x-ray, the patient was contacted on day 14. A second x-ray was ordered if the patient reported that they had still not seen the remnant. Outcome measures were PEG remnant observed in stool or not seen on plain abdominal x-ray, and adverse events.
  
  
  RESULTS
  Forty-two patients were recruited over 29 months: 38 head and neck patients and 4 others (stroke, head injury, cystic fibrosis [CF], and lung cancer). Of these, 41 had passed the remnant by day 8 and all by day 14. No adverse events occurred.
  
  
  CONCLUSIONS
  We have concluded that cut and push is a safe method of removal for Freka 15-Fr PEG tubes in ambulant patients without significant gastrointestinal history.
authors.affiliation: Department of Nutrition and Dietetics, Royak Wolverhampton Hospitals NHS Trust, New Cross Hospital, Wolverhampton, UK. sue.merrick@rwh-tr.nhs.uk
authors.forename: Susan
authors.initials: S
authors.lastname: Merrick
authors.forename: Sarah
authors.initials: S
authors.lastname: Harnden
authors.forename: Shishir
authors.initials: S
authors.lastname: Shetty
authors.forename: Preeti
authors.initials: P
authors.lastname: Chopra
authors.forename: Philip
authors.initials: P
authors.lastname: Clamp
authors.forename: Suneil
authors.initials: S
authors.lastname: Kapadia
mesh_terms: D020878:Device Removal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005774:Gastrostomy; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011860:Radiography, Abdominal; D012449:Safety; D016896:Treatment Outcome