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[A simple method for removal of percutaneous endoscopically implanted gastrostomy tubes].

Percutaneous endoscopic gastrostomy (PEG) has become an accepted technique for providing longterm enteral nutrition. So far the PEG tubes have been removed by a second gastroscopy procedure. Extrusion of the PEG tube and fistula formation have been described as unusual complications. We report about 26 patients with severe brain injuries whose PEG tubes were removed percutaneously by applying constant traction force to the tubes. The soft internal bolsters collapsed and the PEG tubes could be pulled out through the gastrostomy site within 5-7 days. The gastrocutaneous fistulae closed spontaneously within 4 days. In one patient the internal bolster got caught in the external layer of the rectus muscle sheath and had to be removed through a small incision. There were no other complications and 21 patients rated their well-being as unimpaired. Thus we believe the "traction procedure" to be a simple, safe and cost-effective alternative to endoscopic removal of PEG catheters.