Evidence map›Paper›PMID 24993173›Full record

ArticleSurgical endoscopy2015

Comparison of 231 patients receiving either "pull-through" or "push" percutaneous endoscopic gastrostomy.

Gernot Köhler, Veronika Kalcher, Oliver O Koch, Ruzica-R Luketina, Klaus Emmanuel, Georg Spaun

Abstract readComparative StudyEvaluation Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
  3. Article
  4. American Society for Gastrointestinal Endoscopy guideline on gastrostomy feeding tubes: methodology and review of evidence.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2025
    Article
  5. Article
  6. Article
  7. [Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2023
    Review
  8. Review
  9. Article
  10. Article
  11. Article
  12. Review
  13. Outcomes of push and pull percutaneous endoscopic gastrostomy placements in 854 patients: A single-center study.JGH open : an open access journal of gastroenterology and hepatology · 2022
    Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy.Current gastroenterology reports · 2016
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Gernot KöhlerDepartment of General and Visceral Surgery, Sisters of Charity Hospital, 4010, Linz, Austria, gernot.koehler@bhs.at.
Veronika Kalcher
Oliver O Koch
Ruzica-R Luketina
Klaus Emmanuel
Georg Spaun

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA percutaneous endoscopic gastrostomy (PEG) can be performed as a direct stomach puncture, known as Seldinger technique ("push") or a thread pulling method ("pull"). The aim of this study was to compare the final results deriving from both application methods.

methodsData of all pull-through-PEG and push-PEG applications, which had been carried out in our department from 2009 to 2012, were analyzed and compared retrospectively. Data collection included patients' demographics, indications, comorbidities, peri-interventional chemotherapy, and/or radiotherapy. The complications were graded according to the Clavien-Dindo classification and divided in early- and late-term complications (before and after 10 days after PEG insertion).

resultsA total of 231 patients received a PEG. Of these, 131 (56.7 %) were treated with pull-through-PEGs and 100 (43.3 %) with the push-PEG method. Overall, in 61 of 231 (26.4 %) patients, a complication was documented and 37 of 61 (60.6 %) were assigned to Clavien-Dindo grade 1. Only 5 of 231 patients (2.2 %) required a re-intervention or surgical treatment under general anesthesia. The overall complication rate was significantly increased by the type of push-PEG tube used (push 33/100 = 33 vs. pull 28/131 = 21.4 %, p = 0.047). A dislocation of the tube was noticed in 5/131 (3.8 %) cases of pull-PEGs and 12/100 (12 %) cases of push PEGs (p = 0.018). An occlusion of the PEG also occurred significantly more frequent in connection with the push-PEG (10/100 = 10 vs. 1/131 = 0.8 %; p < 0.001).

conclusionBoth PEG techniques are safe and well established. Push PEG showed a significantly higher rate of overall complications, dislocations, and occlusions. The decision which PEG tube should be used depends on individual conditions with preference of push-PEGs in patients with head, neck, and esophageal cancer.

Indexed as

AdultAgedAged, 80 and overEquipment FailureFemaleFollow-Up StudiesGastroscopyGastrostomyHumansMaleMiddle AgedOutcome Assessment, Health CarePostoperative ComplicationsRetrospective Studies

Identifiers

PMID24993173

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.