TTP4.10 A systematic review comparing the outcomes of patients undergoing endoscopic versus interventional radiologic gastrostomy: a meta-analysis of the randomised control trials

Aim The aim of this meta-analysis is to compare the post procedure outcomes of percutaneous endoscopic gastrostomy (PEG) versus radiologically inserted gastrostomy (RIG). Methods Three randomised, controlled trials (RCTs) reporting the outcomes for patients undergoing RIG versus PEG for various indications were selected from medical electronic databases and meta-analysis was conducted by using the statistical software RevMan version 5.4. Results Three RCTs on 341 patients reporting post-procedure outcomes were suitable for analysis. In the random effect model analysis, the total complication rate [odds ratio (OR) 1.81, 95%, CI (0.79, 4.17), z = 1.40, P = 0.16], major complication rate odds ratio (OR) 1.93, 95%, CI (0.77, 4.84), z = 1.41, P = 0.16] and procedural mortality rate odds ratio (OR) 1.64, 95%, CI (0.41, 6.50), z = 0.70, P = 0.48] were statistically similar between RIG and PEG groups. The procedure related technical issues were also comparable between the two groups [OR 2.45, 95%, CI (0.46, 12.94), z = 1.05, P = 0.29]. However, there was significant statistical heterogeneity odds ratio (Tau2 = 1.04, chi2 = 7.93, df = 2, p =0.02, I2 = 75%) 1.81, 95%, CI (0.79, 4.17), z = 1.40, P = 0.16] among the included studies. Conclusion Both RIG and PEG are safe, feasible and technically acceptable procedures with comparable outcomes. Due to the paucity of the RCTs, a major multi-centre RCT is needed to strengthen the findings of this study.