title: Percutaneous endoscopic gastrostomy under steady pressure automatically controlled endoscopy: First clinical series.
abstract: OBJECTIVE
  To elucidate the safety of percutaneous endoscopic gastrostomy (PEG) under steady pressure automatically controlled endoscopy (SPACE) using carbon dioxide (CO2).
  
  
  METHODS
  Nine patients underwent PEG with a modified introducer method under conscious sedation. A T-tube was attached to the channel of an endoscope connected to an automatic surgical insufflator. The stomach was inflated under the SPACE system. The intragastric pressure was kept between 4-8 mmHg with a flow of CO2 at 35 L/min. Median procedure time, intragastric pressure, median systolic blood pressure, partial pressure of CO2, abdominal girth before and immediately after PEG, and free gas and small intestinal gas on abdominal X-ray before and after PEG were recorded.
  
  
  RESULTS
  PEG was completed under stable pneumostomach in all patients, with a median procedural time of 22 min. Median intragastric pressure was 6.9 mmHg and median arterial CO2 pressure before and after PEG was 42.1 and 45.5 Torr (NS). The median abdominal girth before and after PEG was 68.1 and 69.6 cm (NS). A mild free gas image after PEG was observed in two patients, and faint abdominal gas in the downstream bowel was documented in two patients.
  
  
  CONCLUSIONS
  SPACE might enable standardized pneumostomach and modified introducer procedure of PEG.
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Hiroyuki
authors: H
authors: Imaeda
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Kiyokazu
authors: K
authors: Nakajima
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Naoki
authors: N
authors: Hosoe
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Masanori
authors: M
authors: Nakahara
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Shinichiro
authors: S
authors: Zushi
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Motohiko
authors: M
authors: Kato
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Kazuhiro
authors: K
authors: Kashiwagi
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Yasushi
authors: Y
authors: Matsumoto
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Kayoko
authors: K
authors: Kimura
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Rieko
authors: R
authors: Nakamura
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Norihito
authors: N
authors: Wada
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Masahiko
authors: M
authors: Tsujii
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Naohisa
authors: N
authors: Yahagi
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Toshifumi
authors: T
authors: Hibi
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Takanori
authors: T
authors: Kanai
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Tetsuo
authors: T
authors: Takehara
authors: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors: Haruhiko
authors: H
authors: Ogata
keywords: Carbon dioxide; Percutaneous endoscopic gastrostomy; Steady pressure automatically controlled endoscopy