Endoscopic vs radiologic gastrostomy for enteral feeding:A systematic review and meta-analysis  

作　　者：Evellin Souza Valentim dos Santos Guilherme Henrique Peixoto de Oliveira Diogo Turiani Hourneaux de Moura Bruno Salomão Hirsch Roberto Paolo Trasolini Wanderley Marques Bernardo Eduardo GuimarãesHourneaux de Moura 

机构地区：[1]Department of Gastroenterology,Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo,São Paulo 05403-010,Brazil [2]Department of Gastroenterology and Hepatology,Hospital Harvard Medical School,Boston,MA 02115,United States

出　　处：《World Journal of Meta-Analysis》2023年第6期277-289,共13页世界荟萃分析杂志

摘　　要：BACKGROUND Percutaneous endoscopic gastrostomy(PEG)and percutaneous radiological gastrostomy(PRG)are minimally invasive techniques commonly used for prolonged enteral nutrition.Despite safe,both techniques may lead to complications,such as bleeding,infection,pain,peritonitis,and tube-related complications.The literature is unclear on which technique is the safest.AIM To establish which approach has the lowest complication rate.METHODS A database search was performed from inception through November 2022,and comparative studies of PEG and PRG were selected following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.All included studies compared the two techniques directly and provided absolute values of the number of complications.Studies with pediatric populations were excluded.The primary outcome of this study was infection and bleeding.Pneumonia,peritonitis,pain,and mechanical complications were secondary outcomes.The risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials(RoB2)and we used The Risk of Bias in Nonrandomized Studies(ROBINS-I)to analyze the retrospective studies.We also performed GRADE analysis to assess the quality of evidence.Data on risk differences and 95%confidence intervals were obtained using the Mantel-Haenszel test.RESULTS Seventeen studies were included,including two randomized controlled trials and fifteen retrospective cohort studies.The total population was 465218 individuals,with 273493 having undergone PEG and 191725 PRG.The only outcome that showed a significant difference was tube related complications in retrospective studies favoring PEG(95%CI:0.03 to 0.08;P<0.00001),although this outcome did not show significant difference in randomized studies(95%CI:-0.07 to 0.04;P=0.13).There was no difference in the analyses of the following outcomes:infection in retrospective(95%CI:-0.01 to 0.00;P<0.00001)or randomized(95%CI:-0.06 to 0.04;P=0.44)studies;bleeding in retrospective(95%CI:-0.00 to 0.00;P<0.00001)or randomized(95%CI:-0.

关 键 词：GASTROSTOMY Adverse events META-ANALYSIS Percutaneous endoscopic Radiological gastrostomy 

分 类 号：R57[医药卫生—消化系统]