A randomized trial of polyurethane and silicone percutaneous endoscopic gastrostomy catheters

Background: No data are available on differences in complication rate and long-term functioning between polyurethaneand silicone percutaneous endoscopic gastrostomy(PEG) catheters. Methods: We randomized patients who qualified for PEG placement to receive either a polyurethaneor silicone PEG catheter. Patients were prospectively monitored for 28 days after placement for the occurrence of complications. Data on long-term PEG survival were obtained retrospectively from the Hospital and general practitioner’s medical records. Results: One hundred and six patients were randomized ( polyurethane50, silicone 56). During the first four weeks of follow-up, major complications occurred twice with both polyurethaneand silicone PEGs ( relative risk1.1, 95% confidence interval: 0.11–11). Overall complications occurred four times with polyurethaneand 17 times with silicone PEGs ( relative risk3.8, 95% confidence interval: 1.37–10.5). Long-term follow-up was available in 96 patients. Seven polyurethanePEGs and 10 silicone PEGs were removed because of PEG malfunctioning, the remainder functioned well until death or the reinstitution of oral feeding. The median complication-free survival was 916 days for the polyurethanePEG and 354 days for the silicone PEG ( Log rank test: P=0.24). Conclusion: PolyurethanePEG catheters were associated with less short-term complications than silicone catheters, but major complications and long-term function were comparable.