title: Early complications following percutaneous endoscopic gastrostomy: results of use of a new direct technique.
abstract: OBJECTIVE
  Percutaneous endoscopic gastrostomy is the standard method for enteral feeding in patients predicted to require long-term enteral nutrition because of dysphagia. A direct techinique with gastropexy is available, in which oropharyngeal passage of the internal bumper can be avoided. The aim of this study was to assess the early complications of percutaneous endoscopic gastrostomy performed using the new direct technique.
  
  
  METHODS
  Between August 2005 and July 2009, 231 patients underwent percutaneous endoscopic gastrostomy at our hospital. We analyzed the clinical characteristics of the patients related to the development of early complications such as bleeding or local infection. Early complications were defined as complications occurring within 7 days of the percutaneous endoscopic gastrostomy.
  
  
  RESULTS
  The study population comprised 231 patients: 157 men and 74 women (median age, 73 years; range, 28-92 years). The percutaneous endoscopic gastrostomy was performed using the pull-through technique in 134 of these patients (58%), whereas the direct technique with gastropexy was employed in the remaining 97 patients (42%). In the multiple logistic regression analyses, only the use/non-use of the direct technique was identified as a variable significantly associated with the incidence of bleeding (odds ratio 5.236, 95% confidence interval 1.040-26.316; p = 0.0447) and the incidence of local infection (odds ratio 0.283, 95% confidence interval 0.100-0.802; p = 0.0175).
  
  
  CONCLUSIONS
  Use of the direct technique for performing percutaneous endoscopic gastrostomy was associated with the increased incidence of the early complication of bleeding, but the decreased incidence of local infection.
authors: Gastroenterology Division, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
authors: Tomoko
authors: T
authors: Koide
authors: Masahiko
authors: M
authors: Inamori
authors: Akihiho
authors: A
authors: Kusakabe
authors: Takashi
authors: T
authors: Uchiyama
authors: Seitaro
authors: S
authors: Watanabe
authors: Hiroshi
authors: H
authors: Iida
authors: Hiroki
authors: H
authors: Endo
authors: Kunihiro
authors: K
authors: Hosono
authors: Yasunari
authors: Y
authors: Sakamoto
authors: Koji
authors: K
authors: Fujita
authors: Hirokazu
authors: H
authors: Takahashi
authors: Masato
authors: M
authors: Yoneda
authors: Chikako
authors: C
authors: Tokoro
authors: Hiroaki
authors: H
authors: Yasuzaki
authors: Ayumu
authors: A
authors: Goto
authors: Yasunobu
authors: Y
authors: Abe
authors: Noritoshi
authors: N
authors: Kobayashi
authors: Kensuke
authors: K
authors: Kubota
authors: Satoru
authors: S
authors: Saito
authors: Atsushi
authors: A
authors: Nahajima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D004750:Enteral Nutrition / Q000295:instrumentation*; D005260:Female; D020699:Gastroscopes; D005774:Gastrostomy / Q000295:instrumentation*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric