Percutaneous endoscopic gastrostomy with Funada-style gastropexy greatly reduces the risk of peristomal infection

Abstract

Background and aims: 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.Conclusion: 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.

The management of gastric volvulus in elderly patients

“…In contrast, gastrostomy is usually not necessary for patients who can receive adequate oral nutrition and have good activity levels, and endoscopic gastropexy alone should be adequate as described above for patient 1. We use a Funada-style gastropexy device during the process of percutaneous endoscopic gastrostomy [8].…”

Peritonitis after percutaneous endoscopic gastrojejunostomy for levodopa–carbidopa intestinal gel treatment despite concomitant use of gastropexy

“…PEG‐J devices (AbbVie, North Chicago, IL) are placed using the standard pull method. However, the pull method reportedly has a higher incidence of postoperative peritonitis than the push method with gastropexy . The gastropexy devices comprise two parallel needles and a suture‐holding loop to percutaneously and tightly suture the stomach to the abdominal wall .…”

Gastrostomía Endoscópica -Through Como Dispositivo De Instalación

“…Existen varios autores entusiastas con la gastropexia, que ha demostrado además reducir significativamente las infecciones periostomales. Por otro lado, la gastropexia aumenta la complejidad, duración y costo del procedimiento 13 . Existe una técnica combinada de acceso transabdominal llamada Versa (T-fasteners) 14 .…”