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Abstract：
OBJECTIVE: Percutaneous endoscopic gastrostomy (PEG) and radiologically inserted gastrostomy (RIG) have gained increasing popularity among clinicians and motor neuron disease (MND) patients for maintaining adequate nutritional intake. However, there is no consistent evidence of the efficacy and safety of the two techniques in MND patients. We carried out a systematic review and meta-analysis to examine the technical success rates, complication rates and 30-day mortality of MND patients receiving PEG and RIG.
METHODS: We searched PubMed, EMBASE, the Cochrane Library, Web of Science and Scopus from inception to September 12, 2019 for comparative studies on the efficacy and safety of PEG and RIG in MND patients. The primary outcome was technical success rate and the secondary outcomes were complication rates and 30-day mortality.
RESULTS: Seven studies (n = 603) were included. Pooled technical success rates were 90.15% in patients receiving PEG and 96.76% in patients undergoing RIG. There was a statistically significant difference in the technical success rate between RIG and PEG, strongly favoring RIG [(OR = 3.96, 95% CI (1.31to 12.02); P = .02]. Pooled major complication rates were 2.19% in patients receiving PEG and 0.07% in patients undergoing RIG, with no statistical difference (P = .08). Pooled procedure-related 30-day mortality rates were 5.31% in patients receiving PEG and 6.00% in patients undergoing RIG, with no statistically significant difference (P = .75). No publication bias was noted.
CONCLUSIONS: The present meta-analysis demonstrated that, compared to PEG, RIG has a higher technical success rate and has a comparable mortality outcome and safety profile.
METHODS: We searched PubMed, EMBASE, the Cochrane Library, Web of Science and Scopus from inception to September 12, 2019 for comparative studies on the efficacy and safety of PEG and RIG in MND patients. The primary outcome was technical success rate and the secondary outcomes were complication rates and 30-day mortality.
RESULTS: Seven studies (n = 603) were included. Pooled technical success rates were 90.15% in patients receiving PEG and 96.76% in patients undergoing RIG. There was a statistically significant difference in the technical success rate between RIG and PEG, strongly favoring RIG [(OR = 3.96, 95% CI (1.31to 12.02); P = .02]. Pooled major complication rates were 2.19% in patients receiving PEG and 0.07% in patients undergoing RIG, with no statistical difference (P = .08). Pooled procedure-related 30-day mortality rates were 5.31% in patients receiving PEG and 6.00% in patients undergoing RIG, with no statistically significant difference (P = .75). No publication bias was noted.
CONCLUSIONS: The present meta-analysis demonstrated that, compared to PEG, RIG has a higher technical success rate and has a comparable mortality outcome and safety profile.
摘要：
目的：经皮内镜胃造瘘术（PEG）和放射学插入胃造瘘术（RIG）在临床医生和运动神经元疾病（MND）患者中获得越来越多的普及，以维持充足的营养摄入。然而,没有一致的证据证明两种技术在MND患者中的有效性和安全性.我们进行了系统的回顾和荟萃分析，以检查技术成功率，接受PEG和RIG治疗的MND患者的并发症发生率和30天死亡率.
方法：我们搜索了PubMed，EMBASE,Cochrane图书馆,WebofScience和Scopus从成立到2019年9月12日，对PEG和RIG在MND患者中的疗效和安全性进行比较研究。主要结果是技术成功率，次要结果是并发症发生率和30天死亡率。
结果：纳入7项研究（n=603）。接受PEG的患者的汇总技术成功率为90.15％，接受RIG的患者为96.76％。RIG与PEG技术成功率有统计学差异,强烈支持RIG[（OR=3.96，95%CI（1.31至12.02）；P=.02]。在接受PEG治疗的患者中，合并的主要并发症发生率为2.19%，在接受RIG治疗的患者中为0.07%。无统计学差异(P=.08)。合并手术相关的30天死亡率在接受PEG的患者中为5.31%，在接受RIG的患者中为6.00%。差异无统计学意义(P=0.75)。没有发现发表偏倚。
结论：本荟萃分析表明，与PEG相比，RIG具有更高的技术成功率，并且具有可比的死亡率结果和安全性。
方法：我们搜索了PubMed，EMBASE,Cochrane图书馆,WebofScience和Scopus从成立到2019年9月12日，对PEG和RIG在MND患者中的疗效和安全性进行比较研究。主要结果是技术成功率，次要结果是并发症发生率和30天死亡率。
结果：纳入7项研究（n=603）。接受PEG的患者的汇总技术成功率为90.15％，接受RIG的患者为96.76％。RIG与PEG技术成功率有统计学差异,强烈支持RIG[（OR=3.96，95%CI（1.31至12.02）；P=.02]。在接受PEG治疗的患者中，合并的主要并发症发生率为2.19%，在接受RIG治疗的患者中为0.07%。无统计学差异(P=.08)。合并手术相关的30天死亡率在接受PEG的患者中为5.31%，在接受RIG的患者中为6.00%。差异无统计学意义(P=0.75)。没有发现发表偏倚。
结论：本荟萃分析表明，与PEG相比，RIG具有更高的技术成功率，并且具有可比的死亡率结果和安全性。
