Dwell time and functional failure in percutaneous endoscopic gastrostomy tubes: a prospective randomized-controlled comparison between silicon polymer and polyurethane percutaneous endoscopic gastrostomy tubes

Aliment Pharmacol Ther. 2004 Oct 15;20(8):875-82. doi: 10.1111/j.1365-2036.2004.02191.x.

Abstract

Background: Silicone percutaneous endoscopic gastros-tomy (PEG) tubes are associated with more short-term complications and possibly fail sooner than those made of polyurethane. Understanding the deterioration and long-term complications leading to tube failure has important clinical and cost implications.

Aim: To compare dwell time and patterns of failure ofsilicone polymer and polyurethane PEG tubes.

Methods: Participants randomized to receive a siliconepolymer (n = 76) or polyurethane (n = 62) PEG werevisited monthly for 540 days, until death or tube removal. Tube and exit site characteristics and reasons for removal were recorded.

Results: Tube failure occurred in 25% of silicone PEGs and 12.9% of polyurethane PEGs. Mean tube survival for silicone PEGs was 377.2 days (CI: 326-428) and for polyurethane 436.8 days (CI: 383-490; P = 0.13). A greater proportion of silicone PEGs developed intralumenal colonization and altered tube integrity than polyurethane (P < 0.001). Silicone PEGs blocked more frequently (P < 0.005) and were removed because of irreversible blockage more often than polyurethane PEGs (P < 0.05). Silicone PEGs with reversible blockage and tube integrity changes had a significantly greater probability of failure than silicone tubes without these changes (P < 0.005 and P < 0.05, respectively).

Conclusions: Observations over time indicate that sili-cone PEGs are more susceptible than polyurethane PEGs to tube deterioration, resulting in substantially increased management demands to sustain patients' feeding and medication schedules.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Endoscopy, Gastrointestinal*
  • Equipment Contamination
  • Equipment Design
  • Equipment Failure
  • Female
  • Fungi
  • Gastrostomy / instrumentation*
  • Humans
  • Intubation, Gastrointestinal*
  • Male
  • Middle Aged
  • Polyurethanes*
  • Prospective Studies
  • Silicone Elastomers*
  • Time Factors

Substances

  • Polyurethanes
  • Silicone Elastomers