A randomized trial of polyurethane and silicone percutaneous endoscopic gastrostomy catheters

Background: No data are available on differences in complication rate and l ong-term functioning between polyurethane and silicone percutaneous endosco pic gastrostomy (PEG) catheters. Methods: We randomized patients who qualified for PEG placement to receive either a polyurethane or 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 Hosp ital and general practitioner's medical records. Results: One hundred and six patients were randomized (polyurethane 50, sil icone 56). During the first four weeks of follow-up, major complications oc curred twice with both polyurethane and silicone PEGs (relative risk 1.1, 9 5% confidence interval: 0.11-11). Overall complications occurred four times with polyurethane and 17 times with silicone PEGs (relative risk 3.8, 95% confidence interval: 1.37-10.5). Long-term follow-up was available in 96 pa tients. Seven polyurethane PEGs and 10 silicone PEGs were removed because o f PEG malfunctioning, the remainder functioned well until death or the rein stitution of oral feeding. The median complication-free survival was 916 da ys for the polyurethane PEG and 354 days for the silicone PEG (Log rank tes t: P=0.24). Conclusion: Polyurethane PEG catheters were associated with less short-term complications than silicone catheters, but major complications and long-te rm function were comparable.