Validação da gastrostomia endoscópica percutânea realizada pela técnica de punção com o uso de uma nova variante técnica de gastropexia

• Ano de defesa: 2010
• Autor(a) principal: CAMPOLI, Paulo Moacir de Oliveira
• Orientador(a): TURCHI, Marília Dalva
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Goiás
• Programa de Pós-Graduação: Doutorado em Medicina Tropical
• Departamento: Ciências da Saúde
• País: BR
• Palavras-chave em Português: Gastrostomia; procedimento endoscópico; gastropexia
• Palavras-chave em Inglês: Gastrostomy, endoscopic procedure; gastropexy
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::EPIDEMIOLOGIA
• Link de acesso: http://repositorio.bc.ufg.br/tede/handle/tde/1568

Percutaneous endoscopic gastrostomy (PEG) currently represents the main alternative to ensure nutritional supply in patients with prolonged or permanent inability to swallow, and yet has a functional gastrointestinal tract. PEG performed with the Pull Technique is widely used because it is easy to perform and very safe, although it is associated with high infection rates. The Introducer Technique appears to be associated with a lower infection risk, although it requires fixation of the gastric wall to the abdominal wall (gastropexy), which makes the procedure difficult to perform. This study sought to describe and validate PEG performed with the Introducer Technique with the use of a new technical gastropexy variant, besides demonstrating its benefits in relation to risk of peristomal infection. A descriptive study of the safety and feasibility of a new technical gastropexy variant with a long curved needle was performed. We then compared the two gastropexy techniques in a before-and-after design. A randomized clinical trial comparing gastrostomy tubes constructed of different materials (latex vs. silicone) was also conducted. Finally, we performed a meta-analysis evaluating peristomal infection risk between the Introducer Technique and Pull Technique. The results of these four studies are presented in four separate papers. The first study showed that the new technical gastropexy variant that uses a long curved needle is safe and feasible. The second study showed that it is associated with a lower risk of infection compared with the gastropexy technique used previously. The third study found that the silicone tubes have greater durability than latex tubes. The final meta-analysis showed that PEG performed with the Pull Technique is associated with a greater risk of infection than the Introducer Technique.