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

World Journal of Meta-Analysis 2023年第6期11卷 277-289页

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 Department of Gastroenterology Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão Paulo 05403-010Brazil Department of Gastroenterology and Hepatology Hospital Harvard Medical SchoolBostonMA 02115United States

BACKGROUND Percutaneous endoscopic gastrostomy(PEG)and percutaneous radiological gastrostomy(PRG)are minimally invasive techniques commonly used for prolonged enteral *** safe,both techniques may lead to complications,such as bleeding,infection,pain,peritonitis,and tube-related *** literature is unclear on which technique is the *** To establish which approach has the lowest complication *** 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 *** included studies compared the two techniques directly and provided absolute values of the number of *** with pediatric populations were *** primary outcome of this study was infection and ***,peritonitis,pain,and mechanical complications were secondary *** 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 *** also performed GRADE analysis to assess the quality of *** on risk differences and 95%confidence intervals were obtained using the Mantel-Haenszel *** Seventeen studies were included,including two randomized controlled trials and fifteen retrospective cohort *** total population was 465218 individuals,with 273493 having undergone PEG and 191725 *** 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

关键词： Gastrostomy Adverse events Meta-analysis Percutaneous endoscopic Radiological gastrostomy

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