Percutaneous Endoscopic Gastrostomy with T-Fasteners versus “Pull Technique”: Analysis of Complications

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Introduction The T-fasteners gastrostomy (T-PEG) has become increasingly popular over recent years as an alternative to the “pull-technique” gastrostomy (P-PEG). This study aimed to compare P-PEG and T-PEG complications. Materials and Methods A retrospective observational study of pediatric patients who underwent percutaneous endoscopic gastrostomy (PEG) placement. P-PEG was performed using the standard Ponsky technique and was replaced after 6 months by a balloon gastrostomy under sedation. T-PEG was performed using three percutaneous T-fasteners (that allow a primary insertion of a balloon gastrostomy). The balloon was replaced by a new one after 6 months without sedation. Complications were recorded. Results In total, 146 patients underwent PEG placement, 70 P-PEG and 76 T-PEG. The mean follow-up was 3.9 years (standard deviation = 9.6). Age, weight, and associated comorbidities were comparable (p > 0.05). The overall complications were 17 (24.2%) in the P-PEG group and 16 (21.0%) in the T-PEG group (p > 0.05). P-PEG was associated with more sedation for button replacement (97 vs. 2.6% [p

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Article · Jun 2024 · 1 min read

In brief

This retrospective study compares complication rates between traditional pull-technique gastrostomy (P-PEG) and T-fastener gastrostomy (T-PEG) in 146 pediatric patients over nearly 4 years of follow-up. While overall complication rates were similar between techniques, T-PEG offered the advantage of button replacement without sedation, potentially reducing procedural burden in long-term enteral access management.

T-fastener PEG allows primary balloon gastrostomy insertion, eliminating need for sedation at 6-month replacement (2.6% vs 97% sedation rate).
Overall complication rates were comparable between T-PEG and pull-technique PEG (21.0% vs 24.2%, p>0.05) in pediatric patients.
T-fastener technique uses three percutaneous anchors to secure stomach wall before balloon gastrostomy placement.
Mean follow-up of 3.9 years showed both techniques are safe alternatives for pediatric gastrostomy placement.
Pull-technique PEG requires routine sedation for button replacement at 6 months; T-fastener technique does not.

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