Of the 30 patients demographic and clinical features are reported in Table 1. Overall patients underwent a total of 156 PEG-J procedures, of which 20 patients had undergone at least one PEG-J replacement procedure, with a mean follow-up period of 64,4 (3–119) months, and an average of 4 replacements. Only one patient discontinued DLI due to the occurrence of a severe peripheral neuropathy. Over the follow-up period, six patients died, and the reported causes of death were unrelated to DLI. The total mean follow-up was of 21,4 months, with a range of 3 to 54 months. During a 12 months observation period, 14 patients out of 30 (46,7%) reported at least one complication. 8 patients (26,7%) complained about a stoma condition; 11 patients (13,3%) underwent 22 PEG-J replacement procedures due to complications, of which 15 were associated with the tubing system utilized, and 7 with patient related issues. In a 10-year follow-up, nineteen patients (63.3%) had a total of 185 complications, 85 of which were related to stoma issues: stomal erythema (n = 44), serous secretions (n = 20), surgical wound granuloma (n = 9), peristomal edema (n = 6), purulent secretions (n = 3), sero-ematic secretions (n = 2), candida infection (n = 1). 17 patients (56.6%) underwent a total amount of 100 PEG-J replacements due to complications, of which 82 out of 100 were associated with the tubing system utilized [tube dislocation (n = 35), external or internal bumper dislocation (n = 21), tube breaking/puncture (n = 16), device coloring (n = 8), accidental removal (n = 1), candida colonization of the tubing system (n = 1)], while the remaining 18 with patient related issues [abdominal discomfort (n = 9),

Table 1 Demographics, clinical features, PEG-J procedures and related complications

granulation tissue (n = 4), peristomal inflammation (n = 4), buried bumper syndrome (n = 1)] (Table 1). The most common reason given for replacement was J-tube dislocation (36%) in 12 patients (Table 1). A correlation analysis between complications and clinical scales (UPDRS and H&Y) during times of replacement did not find any significant values. However, the small number of patients and the retrospective design of the study could have influenced the results.

The “pull” method was adopted for 41 procedures (from 2009 to 2014) and the “push” method for 79 (from 2015 to 2019). Complications led to tube replacement in 75% of cases with “pull” and 67% of cases with “push” technique. Mean PEG-J duration was of 7,6 and 5,6 months for the “pull” and “push” methods, respectively. A comparison of clinical features for “pull” and “push” technique is reported in Table 2: a t-test (FDR corrected) showed no significant differences for age, disease duration, follow-up duration, UPDRS III score, mH&Y score and PEG-J duration. The paired t-test to compare scheduled replacements and unexpected replacements groups was significant (p < 0.05), however, after the FDR correction for variability did not showed this result due to the low number of subjects for each group (Table 2).

Table 2 PEG-J replacement procedures: “pull” and “push” methods comparison

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Disclaimer:

This article is autogenerated using RSS feeds and has not been created or edited by OA JF.

Click here for Source link (https://www.biomedcentral.com/)