title: Percutaneous endoscopic gastrostomy with Funada-style gastropexy greatly reduces the risk of peristomal infection.
abstract: OBJECTIVE
  Peristomal wound infections are common complications of percutaneous endoscopic gastrostomy (PEG). The Funada-style gastropexy device has two parallel needles with a wire loop and suture thread, and was developed about 20 years ago in Japan. This kit has allowed us to perform dual gastropexy very easily; PEG with gastropexy has become a very popular technique in Japan. The present study aimed to compare the advantages and disadvantages of PEG with the gastropexy technique with the standard 'pull' method.
  
  
  METHODS
  We retrospectively reviewed 182 consecutive, non-randomized patients undergoing PEG in our hospital, and a comparative analysis was made between the gastropexy (87 patients) and non-gastropexy (95 patients) groups.
  
  
  RESULTS
  The rates of patients having erythema (11.6% vs. 47.9%; P < 0.001), exudates (2.3% vs. 14.9%; P < 0.01) and infection (0% vs. 6.4%; P = 0.01) in the peristomal area were lower in the gastropexy than in the non-gastropexy group. The rate of minor bleeding from the peristomal area was higher in the gastropexy than in the non-gastropexy group (12.8% vs. 2.1%; P < 0.01), but no patient required a blood transfusion. Mean procedure time was longer in the gastropexy group than in the non-gastropexy group (31 vs. 24 min; P < 0.001). The 30-day mortality rates were 4.7% and 5.3% respectively, and these deaths were not related to the gastrostomy procedure.
  
  
  CONCLUSIONS
  PEG with gastropexy markedly reduces peristomal inflammation. Although minor bleeding and a longer procedure time were disadvantages, there were no severe complications. The findings suggested that PEG with Funada-style gastropexy was a safe and feasible method for reducing early complications of PEG.
authors.affiliation: Department of Gastroenterology, Sakai Hospital, Kinki University Faculty of Medicine, Sakai, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Okumura
authors.affiliation: Department of Gastroenterology, Sakai Hospital, Kinki University Faculty of Medicine, Sakai, Japan tsuji@sakai.med.kindai.ac.jp.
authors.forename: Naoko
authors.initials: N
authors.lastname: Tsuji
authors.affiliation: Department of Gastroenterology, Sakai Hospital, Kinki University Faculty of Medicine, Sakai, Japan.
authors.forename: Nobuto
authors.initials: N
authors.lastname: Ozaki
authors.affiliation: Department of Gastroenterology, Sakai Hospital, Kinki University Faculty of Medicine, Sakai, Japan.
authors.forename: Nozomu
authors.initials: N
authors.lastname: Matsumoto
authors.affiliation: Department of Gastroenterology, Sakai Hospital, Kinki University Faculty of Medicine, Sakai, Japan.
authors.forename: Takehisa
authors.initials: T
authors.lastname: Takaba
authors.affiliation: Department of Gastroenterology, Sakai Hospital, Kinki University Faculty of Medicine, Sakai, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Kawasaki
authors.affiliation: Department of Gastroenterology, Sakai Hospital, Kinki University Faculty of Medicine, Sakai, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Tomita
authors.affiliation: Department of Gastroenterology, Sakai Hospital, Kinki University Faculty of Medicine, Sakai, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Umehara
authors.affiliation: Department of Gastroenterology, Sakai Hospital, Kinki University Faculty of Medicine, Sakai, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Taniike
authors.affiliation: Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-sayama, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kono
authors.affiliation: Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-sayama, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
keywords: gastropexy; percutaneous endoscopic gastrostomy; peristomal infection