The 'cut and push' method of percutaneous endoscopic gastrostomy tube removal

Background and aims: The standard method of removing percutaneous endoscopi c gastrostomy tubes is by gastroscopy. This has implications for endoscopy time and resources, and we believe is not always necessary. Depending on th e type of percutaneous endoscopic gastrostomy tube used we often used the ' cut and push' method. This involves cutting the catheter at skin level and allowing the tube and internal bumper to spontaneously pass. The cut and pu sh method also represents a considerable resource saving compared to the en doscopic method that we think warrants further discussion. Method: We reviewed all the files of the percutaneous endoscopic gastrostom y tubes removed in our unit over the last 4 years. Results: During the period of July 1995 to July 1999, we have inserted 384 percutaneous endoscopic gastrostomy tubes. Seven tubes have been removed en doscopically and 73 tubes have been removed with the cut and push method. O nly two possible complications have been recorded (2.7%). Conclusions: We believe that we have provided further evidence that percuta neous endoscopic gastrostomy tubes can be removed safely using the cut and push method. Patients who are often frail and who have multiple medical pro blems are saved an often-long journey to the endoscopy unit as well as the hazards of an endoscopy. The saving in resources in what is already an over worked system by not performing endoscopies is also considerable. (C) 2000 Harcourt Publishers Ltd.