Simone Simoni, Pasquale Nigro, Marta Filidei, Giulia Cappelletti, Federico Paolini Paoletti, Danilo Castellani, Mirko Gaggiotti, Lucilla Parnetti, Nicola Tambasco
BMC neurology 2022 Jan 13Reducing percutaneous endoscopic gastrostomies with jejunal extension tubes (PEG-J) related complications is vital to the long-term preservation of duodenal levodopa infusion (DLI) in advanced Parkinson's disease (APD). Here, we provide data on the frequency of complications for both the standard "pull" and the non-endoscopic, radiologic assisted, "push" replacement PEG-J techniques in APD. We retrospectively identified all patients treated with DLI from October 2009 to January 2020 at the Movement Disorders Center. Patients features and demographics, PEG-J procedures, causes for any discontinuation, reported complications and mortality were collected. In this cohort, PEG-J replacements were performed using the standard "pull" procedure or the radiologic assisted "push" method. Descriptive statistical analysis, t-test and paired t-test with False Discovery Rate correction was performed. This retrospective study included 30 APD patients [median age 72 ± 5.6 years; mean disease duration 17.2 + 5.7 years]. Mean treatment duration was 35.6 (30.6) months. Overall, 156 PEG-J procedures were performed, and Nineteen patients (63.3%) had a total of 185 reported complications, 85 of which were peristomal complications. 17 (56.6%) underwent 100 replacement procedures due to complications. The most commonly reported complication for replacement was J-tube dislocation (36%). One patient discontinued treatment after 6 months, due to peripheral neuropathy. Six patients died for causes not related to DLI. PEG-J replacements performed with the "push" method had a higher turnover (5.6 vs. 7.6 mo.), but fewer reported complications (67 vs. 75%). The overall rate of complications was lower for "push" technique. This result might have been due to a higher replacement turnover that acted as a protective factor. © 2022. The Author(s).
Simone Simoni, Pasquale Nigro, Marta Filidei, Giulia Cappelletti, Federico Paolini Paoletti, Danilo Castellani, Mirko Gaggiotti, Lucilla Parnetti, Nicola Tambasco. PEG-J replacement for duodenal levodopa infusion in Parkinson's disease patients: a retrospective study. BMC neurology. 2022 Jan 13;22(1):25
PMID: 35026993
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