Usefulness of a continuous suction mouthpiece during percutaneous endoscopic gastrostomy: a single-center, prospective, randomized study.
BACKGROUND
No mouthpiece has been designed to control salivary flow during endoscopic procedures. A new continuous suction mouthpiece (CSM) was developed, and its usefulness for percutaneous endoscopic gastrostomy (PEG) was evaluated.


METHODS
Seventy-two patients who were scheduled to undergo PEG or the exchange of a gastrostomy button or tube were assigned to one of two groups: the group using the CSM and the group using the conventional mouthpiece. Aspiration pneumonia, procedure duration, extent of salivary flow, frequency of saliva suction, and number of choking episodes during the procedures were evaluated and compared between the two groups.


RESULTS
The same number of patients was randomly allocated to each group. There were no significant differences between the two groups in sex, age, procedure type, duration of procedure,depth of sedation, and indication for the procedure. The grade of salivary flow was significantly lower in patients with the CSM than in patients with the conventional mouthpiece (P < 0.001). Significantly fewer suctions and choking episodes were observed in patients with the CSM than in patients with the conventional mouthpiece (P = 0.013, and P = 0.015, respectively). Aspiration pneumonia and other significant adverse events were not observed in either group.


CONCLUSIONS
CSM reduced the number of episodes associated with salivary flow in PEG-related procedures. The device is expected to reduce complications such as aspiration not only in PEG but in other upper endoscopic procedures.
Department of Gastroenterology, School of Medicine, Wakayama Medical University, Wakayama, Japan. maekita@wakayama-med.ac.jp
Takao
T
Maekita
Jun
J
Kato
Yukihiko
Y
Nakatani
Shotaro
S
Enomoto
Takashi
T
Kayama
Masahiro
M
Tsuji
Tsuyoshi
T
Nakaya
Yosuke
Y
Muraki
Hisanobu
H
Deguchi
Kazuki
K
Ueda
Izumi
I
Inoue
Mikitaka
M
Iguchi
Hideyuki
H
Tamai
Masao
M
Ichinose
D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition / Q000379:methods; D005260:Female; D005773:Gastroscopy / Q000379:methods*; D005774:Gastrostomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009055:Mouth; D011446:Prospective Studies; D018570:Risk Assessment; D012463:Saliva / Q000378:metabolism*; D013396:Suction / Q000295:instrumentation*; D016896:Treatment Outcome
aspiration; mouthpiece; percutaneous endoscopic gastrostomy; salivary flow