dos Santos ESV, de Oliveira GHP, de Moura DTH, Hirsch BS, Trasolini RP, Bernardo WM, de Moura EGH. Endoscopic vs radiologic gastrostomy for enteral feeding: A systematic review and meta-analysis. World J Meta-Anal 2023; 11(6): 277-289 [DOI: 10.13105/wjma.v11.i6.277]
Corresponding Author of This Article
Guilherme Henrique Peixoto de Oliveira, MD, Medical Assistant, Department of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar, 225, São Paulo 05403-010, Brazil. guilherme.hpoliveira@hc.fm.usp.br
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Meta-Anal. Sep 18, 2023; 11(6): 277-289 Published online Sep 18, 2023. doi: 10.13105/wjma.v11.i6.277
Endoscopic vs radiologic gastrostomy for enteral feeding: A systematic review and meta-analysis
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 Guimarães Hourneaux de Moura
Evellin Souza Valentim dos Santos, Guilherme Henrique Peixoto de Oliveira, Diogo Turiani Hourneaux de Moura, Bruno Salomão Hirsch, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura, Department of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 05403-010, Brazil
Roberto Paolo Trasolini, Department of Gastroenterology and Hepatology, Hospital Harvard Medical School, Boston, MA 02115, United States
Author contributions: dos Santos ESV contributed acquisition of data, analysis, interpretation of data, drafting the article, revising the article, final approval; de Oliveira GHP, dos Santos ESV and Hirsch BS contributed analysis and interpretation of data, revising the article; de Moura DTH contributed analysis of data, interpretation of data, drafting the article, revising the article, final approval; Bernardo WM contributed analysis of data, interpretation of data, drafting the article, revising the article, final approval; de Moura EGH contributed analysis and interpretation of data, drafting the article, revising the article, final approval.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guilherme Henrique Peixoto de Oliveira, MD, Medical Assistant, Department of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr Enéas de Carvalho Aguiar, 225, São Paulo 05403-010, Brazil. guilherme.hpoliveira@hc.fm.usp.br
Received: February 28, 2023 Peer-review started: February 28, 2023 First decision: March 24, 2023 Revised: May 17, 2023 Accepted: June 16, 2023 Article in press: June 16, 2023 Published online: September 18, 2023 Processing time: 196 Days and 14.8 Hours
ARTICLE HIGHLIGHTS
Research background
Gastrostomy feeding is superior to nasogastric tube feeding when medium to long-term enteral feeding (≥ 4 wk) is indicated. The optimal technique for long-term enteral feeding is not yet well established. Therefore, we performed a meta-analysis comparing the two methods.
Research motivation
This paper motivation is to demonstrate which technique for performing a gastrostomy has the lowest incidence rate of adverse events.
Research objectives
The aim of the paper is to compare the technique of endoscopic gastrostomy (PEG) and gastrostomy via interventional radiology (PRG) and establish which technique is the safest for the patient.
Research methods
Comparative studies of PEG and PRG were selected. Included studies had outcomes such as infection, bleeding, pneumonia, pain, peritonitis and tube related complications. The risk of bias and quality of evidence were assessed. The analysis was performed using Review Manager (RevMan 5.4) from the Cochrane Informatics & Knowledge Management Department website.
Research results
Seventeen studies were included, with a total of 465218 patients. 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: -0.06 to 0.02; P = 0.43) studies; pneumonia in retrospective (95%CI: -0.04 to 0.00; P = 0.28) or randomized (95%CI: -0.09 to 0.11; P = 0.39) studies; pain in retrospective (95%CI: -0.05 to 0.02; P < 0.00001) studies; peritonitis in retrospective (95%CI: -0.02 to 0.01; P < 0.0001) studies.
Research conclusions
The study concluded that RIG has a higher incidence of tube-related complications than PEG. This difference is probably associated with the caliber of the tubes used. There was no statistical difference in the other outcomes evaluated.
Research perspectives
This study aimed to determine which technique is safer for the patient, and both methods proved to be safe. We can conclude that the choice of technique depends on the type of patient, the experience of the service, the cost, and the availability of the method.
