Endoscopic holder-assisted percutaneous endoscopic gastrostomy placement: results of a prospective, randomized comparison study.

BACKGROUND: We developed a new method of endoscope holder-assisted percutaneous endoscopic gastrostomy (PEG) placement requiring only a single physician. OBJECTIVE: This study compared the feasibility and safety of the new method with the conventional pull method of PEG performed by 2 physicians. DESIGN: Prospective, randomized comparison study. SETTING: Rural municipal hospital. PATIENTS: Eighty consecutive patients with dysphagia. INTERVENTIONS: Patients were randomized to receive PEG placement by a single physician using the endoscope holder (40 patients) or by 2 physicians using the conventional pull method (40 patients). MAIN OUTCOME MEASUREMENTS: The success rate, duration, and complications of both methods were scored. RESULTS: The success rate of PEG by either method was similar (98%) using the endoscope holder compared with 100% with the conventional method. The duration of both endoscopic procedures was also similar (12.9 +/- 2 and 11.5 +/- 2 minutes) (P = .43). No major complication occurred with either procedure. There was 1 death within 30 days (of aspiration pneumonia) 3 days after conventional PEG placement. LIMITATIONS: The number of patients evaluated is small. CONCLUSIONS: Endoscope holder-assisted PEG placement allows a single physician to perform all the important aspects of pull PEG placement under direct vision without assistance from another specially trained individual. The method appears to be as feasible and safe as the conventional pull method. [ABSTRACT FROM AUTHOR]