Stroke: polyurethane PEG catheters led to fewer complications than silicone ones

Clinical bottom line (level 1b)

  1. Patients requiring percutaneous endoscopic gastrostomy who received a polyurethane PEG catheter compared with a silicone one were less likely to have complications (NNT = 4 at 4 weeks) .
  2. There was no clear difference in duration of PEG survival or need for withdrawal due to malfunction between the two groups.
van den Hazel et al: Aliment Pharmacol Ther 2000; 14 : 1273-1277
Expires November 2003

The study

Double-blinded ?concealed randomised trial with intention-to-treat
Setting: gastroenterology department, acute hospital, the Netherlands

106 patients (aged mean 63, 51% male) requiring percutaneous endoscopic gastrostomy catheter insertion
Control Group: (n = 5p0, 50 analysed): polyurethane PEG catheter
Experimental Group: (n = 56, 56 analysed): silicone PEG catheter

90% followed for 3 years
Outcome notes:
  • any complication : wound infection, pain, bleeding, peristomal leakage, obstruction, displacement

The evidence

Outcome Time to outcome CER EER RRR
(95% CI)		 ARR
(95% CI)		 NNT
(95% CI)
any complication 28 days 4
(8.00%)		 17
(30.4%)		 -280%
(-950% to -37%)		 -22.4%
(-36.6% to -8.16%)		 -4
(-12 to -3)
removed due to malfunction 3 years 7
(14.0%)		 10
(17.9%)		 -28%
(-210% to 47%)		 -3.86%
(-17.8% to 10.0%)		 -26
(NNT = 10 to infinity;
NNH = 6 to infinity)

Comments

  1. Median PEG survival was similar between the two groups.

Citation

  1. van den Hazel SJ, Mulder CJ, den Hartog G: a randomized trial of polyurethane and silicone percutaneous endoscopic gastrostomy catheters. Aliment Pharmacol Ther 2000; 14 : 1273-1277
Search Terms: from ACP Journal Club other articles noted
Contributor: Chris Ball, November 2001
Reviewer:

Clinical Question.
Patient requiring percutaneous endoscopic gastrostomy tube insertion
Intervention or Exposure polyurethane PEG catheter
Comparison silicone PEG catheter
Outcome complications, removal due to malfunction