PEG-J replacement for duodenal levodopa infusion in Parkinson’s disease patients: a retrospective study
Abstract Background Reducing 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...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | BMC Neurology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12883-021-02546-5 |
| _version_ | 1818752800865124352 |
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| author | Simone Simoni Pasquale Nigro Marta Filidei Giulia Cappelletti Federico Paolini Paoletti Danilo Castellani Mirko Gaggiotti Lucilla Parnetti Nicola Tambasco |
| author_facet | Simone Simoni Pasquale Nigro Marta Filidei Giulia Cappelletti Federico Paolini Paoletti Danilo Castellani Mirko Gaggiotti Lucilla Parnetti Nicola Tambasco |
| author_sort | Simone Simoni |
| collection | DOAJ |
| description | Abstract Background Reducing 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. Methods 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. Results 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%). Conclusion 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. |
| first_indexed | 2024-12-18T04:57:14Z |
| format | Article |
| id | doaj.art-f636a9e511a3415eb5d170425d8e72fa |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-18T04:57:14Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-f636a9e511a3415eb5d170425d8e72fa2022-12-21T21:20:14ZengBMCBMC Neurology1471-23772022-01-012211610.1186/s12883-021-02546-5PEG-J replacement for duodenal levodopa infusion in Parkinson’s disease patients: a retrospective studySimone Simoni0Pasquale Nigro1Marta Filidei2Giulia Cappelletti3Federico Paolini Paoletti4Danilo Castellani5Mirko Gaggiotti6Lucilla Parnetti7Nicola Tambasco8Movement Disorders Center Neurology Department, Perugia General Hospital University of PerugiaMovement Disorders Center Neurology Department, Perugia General Hospital University of PerugiaNeurology Department, Perugia General Hospital University of PerugiaNeurology Department, Perugia General Hospital University of PerugiaNeurology Department, Perugia General Hospital University of PerugiaEndoscopic Section of Gastroenterology and Hepatology, Perugia General Hospital and University of PerugiaEndoscopic Section of Gastroenterology and Hepatology, Perugia General Hospital and University of PerugiaNeurology Department, Perugia General Hospital University of PerugiaMovement Disorders Center Neurology Department, Perugia General Hospital University of PerugiaAbstract Background Reducing 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. Methods 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. Results 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%). Conclusion 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.https://doi.org/10.1186/s12883-021-02546-5Duodenal levodopa infusionPEG-JPEG-J replacementParkinson’s disease |
| spellingShingle | 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 Duodenal levodopa infusion PEG-J PEG-J replacement Parkinson’s disease |
| title | PEG-J replacement for duodenal levodopa infusion in Parkinson’s disease patients: a retrospective study |
| title_full | PEG-J replacement for duodenal levodopa infusion in Parkinson’s disease patients: a retrospective study |
| title_fullStr | PEG-J replacement for duodenal levodopa infusion in Parkinson’s disease patients: a retrospective study |
| title_full_unstemmed | PEG-J replacement for duodenal levodopa infusion in Parkinson’s disease patients: a retrospective study |
| title_short | PEG-J replacement for duodenal levodopa infusion in Parkinson’s disease patients: a retrospective study |
| title_sort | peg j replacement for duodenal levodopa infusion in parkinson s disease patients a retrospective study |
| topic | Duodenal levodopa infusion PEG-J PEG-J replacement Parkinson’s disease |
| url | https://doi.org/10.1186/s12883-021-02546-5 |
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