Radiologic versus Endoscopic Placement of Percutaneous Gastrostomy in Amyotrophic Lateral Sclerosis: Multivariate Analysis of Tolerance, Efficacy, and Survival

Blondet, A; Lebigot, J.; Nicolas, Guillaume; Boursier, Jérôme; Person, B; Laccoureye, L.; Aubé, Christophe

doi:10.1016/j.jvir.2009.11.022

Cited by 59 publications

(40 citation statements)

References 29 publications

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“…We identified 828 citations through the electronic database search, and 445 citations remained after duplicates were removed. Initial screening of the titles and abstracts resulted in the exclusion of 414 citations, and full texts of the remaining 31 citations were reviewed in detail 891617181920212223242526272829303132333435363738394041424344. An additional 16 citations were excluded after reviewing the full articles, for the following reasons: duplicated reports,424344 noncomparative studies,37 studies with RIG placement after failure of PEG,2535 no data present on 30-day mortality,294041 no reported case of 30-day mortality,192730343638 and review articles 1721.…”

Section: Resultsmentioning

confidence: 99%

Thirty-day mortality after percutaneous gastrostomy by endoscopic versus radiologic placement: a systematic review and meta-analysis

et al. 2016

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Background/AimsA percutaneous gastrostomy can be placed either endoscopically (percutaneous endoscopic gastrostomy, PEG) or radiologically (radiologically-inserted gastrostomy, RIG). However, there is no consistent evidence of the safety and efficacy of PEG compared to RIG. Recently, 30-day mortality has become considered as the most important surrogate index for evaluating the safety and efficacy of percutaneous gastrostomy. The aim of this meta-analysis was to compare the 30-day mortality rates between PEG and RIG.MethodsMajor electronic databases (MEDLINE, Embase, Scopus, and Cochrane library) were queried for comparative studies on the two insertion techniques of gastrostomy among adults with swallowing disturbance. The primary outcome was the 30-day mortality rate after gastrostomy insertion. Forest and funnel plots were generated for outcomes using STATA version 14.0.ResultsFifteen studies (n=2,183) met the inclusion criteria. PEG was associated with a lower risk of 30-day mortality after tube placement compared with RIG (odds ratio, 0.60; 95% confidence interval [CI], 0.38–0.94; P=0.026). The pooled prevalence of 30-day mortality of PEG was 5.5% (95% CI, 4.0%–6.9%) and that of RIG was 10.5% (95% CI, 6.8%–14.3%). No publication bias was noted.ConclusionsThe present meta-analysis demonstrated that PEG is associated with a lower probability of 30-day mortality compared to RIG, suggesting that PEG should be considered as the first choice for long-term enteral tube feeding. Further prospective randomized studies are needed to evaluate and compare the safety of these two different methods of gastrostomy.

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Section: Resultsmentioning

confidence: 99%

Thirty-day mortality after percutaneous gastrostomy by endoscopic versus radiologic placement: a systematic review and meta-analysis

et al. 2016

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“…The cut-off limit for a safe PEG placement has been considered a FVC% ≥ 50 of expected values in dysphagic patients [7] and this has led to the suggestion of percutaneous radiological gastrostomy (PRG) as an alternative procedure to PEG [11,12]. While this latter approach is safe, it however requires the presence of an expert interventional radiologist [12].…”

Section: Introductionmentioning

confidence: 99%

“…While this latter approach is safe, it however requires the presence of an expert interventional radiologist [12]. A few years ago, Gregory et al [13] reported that a PEG device could successfully be placed in a cohort of ALS patients (88% of whom were with a bulbar-onset disease), even when FVC% was scored below 30 of those predicted, with 90% survival at 60 days.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous endoscopic gastrostomy in amyotrophic lateral sclerosis: Effect on survival

Spataro

Ficano

Piccoli

et al. 2011

Journal of the Neurological Sciences

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“…Nutrition entérale [40,64,67]. Toutefois, elle ne semble pas apporter un bénéfice significatif sur la survie [15,67].…”

Section: Encadréunclassified

“…Toutefois, elle ne semble pas apporter un bénéfice significatif sur la survie [15,67]. La voie chirurgicale, plus lourde et à morbidité plus élevée [40], est déconseillée.…”

Section: Encadréunclassified

Prise en charge nutritionnelle dans la sclérose latérale amyotrophique : un enjeu médical et éthique

Lehéricey¹,

Forestier²,

Dupuis

et al. 2012

La Presse Médicale

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Radiologic versus Endoscopic Placement of Percutaneous Gastrostomy in Amyotrophic Lateral Sclerosis: Multivariate Analysis of Tolerance, Efficacy, and Survival

Cited by 59 publications

References 29 publications

Thirty-day mortality after percutaneous gastrostomy by endoscopic versus radiologic placement: a systematic review and meta-analysis

Thirty-day mortality after percutaneous gastrostomy by endoscopic versus radiologic placement: a systematic review and meta-analysis

Percutaneous endoscopic gastrostomy in amyotrophic lateral sclerosis: Effect on survival

Prise en charge nutritionnelle dans la sclérose latérale amyotrophique : un enjeu médical et éthique

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