New "introducer" PEG-gastropexy with T fasteners: a pilot study

context: enteral feeding is indicated for patients unable to maintain appropriate oral intake, and percutaneous endoscopic gastrostomy (peg) is the most adequate long-term enteral access. peristomal infections are the most common complications of peg, occurring in up to 8% of patients, despite the use of prophylactic antibiotics. the "introducer" peg-gastropexy technique avoids peg tube passage through the oral cavity, preventing microorganisms' dislodgment to the peristomal site. objectives: to compare the incidence of peristomal wound infection at 7-day post-procedure after conventional "pull" technique versus a new "introducer" peg-gastropexy kit. secondary outcomes included success rates, procedure time, and other complications. methods: eighteen patients referred for peg placement between june and december 2010 were randomly assigned to "pull" peg with antibiotics or "introducer" peg-gastropexy technique without antibiotics. results: overall success rate for both methods was 100%, although mean procedure duration was higher in the "introducer" peg-gastropexy group (12.6 versus 6.4 minutes, p = 0.0166). infection scores were slightly higher in patients who underwent "pull" peg with antibiotics compared with "introducer" peg-gastropexy without antibiotics (1.33 ± 0.83 versus 0.75 ± 0.67, p = 0.29). conclusion: although procedure duration was longer in the "introducer" peg-gastropexy, infection scores were marginally higher in the "pull" peg technique.