Transcutaneous port for continuous duodenal levodopa/carbidopa administration in Parkinson's disease.
Motor fluctuations in Parkinson's disease (PD) can be reduced by intraduodenal infusion of levodopa-carbidopa (Duodopa®) via percutaneous endoscopic gastrojejunostomy (PEG). We applied the transcutaneous soft-tissue anchored titanium port (T-port) in 15 PD patients with motor fluctuations; 7 Duodopa-naive (non-PEG), and 8 previously receiving Duodopa (former-PEG). Motor scores (UPDRS-III) and quality of life (QOL, PDQ-8) were assessed at baseline and 6 month follow-up. Six patients had local irritation shortly after implantation, persisting in one patient at 6 month follow-up, which led to explantation. After having finished the protocol, four T-ports were explanted in total. UPDRS-III and PDQ-8 scores improved moderately in the non-PEG patients, but remained similar in the former-PEG users. Two former-PEG users developed polyneuropathy. No obstructions, retractions, or leakages occurred. Technical and hygienic properties of the T-port were preferred by most patients. The T-port seems to be suitable for most PD patients qualifying for Duodopa therapy, although local infection may lead to explantation during longer-term follow-up.
Department of Neurology, University Medical Center Groningen, Groningen, The Netherlands.
Anne Marthe
AM
Meppelink
Rickard
R
Nyman
Teus
T
van Laar
Martje
M
Drent
Ted
T
Prins
Klaus Leonhard
KL
Leenders
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002230:Carbidopa / Q000008:administration & dosage* / Q000627:therapeutic use; D004338:Drug Combinations; D004386:Duodenum; D005260:Female; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D017060:Patient Satisfaction; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D004338:Drug Combinations; D007980:Levodopa; D002230:Carbidopa