Gastrostomy is recommended for
Amyotrophic Lateral Sclerosis (ALS) patients with
malnutrition. There are two main methods of
gastrostomy insertion: Percutaneous Endoscopic
Gastrostomy (PEG) and Fluoroscopic
Gastrostomy (FG). The latter included Radiologically Inserted
Gastrostomy (RIG) and Per-oral Image-Guided
Gastrostomy (PRG). A meta-analysis was conducted to compare these approaches in terms of survival outcomes,
pain occurrence and success rate, through the literature search in PubMed, Web of Science and Cochrane Library. A total of 7 studies with 701 cases (322 in PEG, 264 in RIG and 115 in PRG) were enrolled in the final analysis. The lack of differences between the comparisons (PEG vs. PRG, PEG vs. RIG and PEG vs. PRG+RIG) on 30-day mortality and survival length was confirmed. For the pooling analysis of peri- and post-procedural complications, patients with PEG had a lower incidence of
pain than cases with PRG and RIG together (P < 0.001). The same trends could be found when compared with PRG and RIG, separately (P < 0.05 and P < 0.001, respectively). And PEG showed a lower rate of successful attempts than PEG and RIG (P < 0.05). For other complications, we didn't find any differences. This meta-analysis demonstrates that PEG, PRG and RIG had their intrinsic advantages. The current evidences could not determine the preference of them. Further investigations should be done to reveal the most appropriate method for ALS patients.