Electromagnetic-guided versus endoscopic placement of post-pyloric feeding tubes: a systematic review and meta-analysis
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RESEARCH
Open Access
Electromagnetic-guided versus endoscopic placement of post-pyloric feeding tubes: a systematic review and meta-analysis of randomised controlled trials Yaping Wei†, Zheng Jin†, Ying Zhu and Wei Hu*
Abstract Background: Current evidence supporting the utility of electromagnetic (EM)-guided method as the preferred technique for post-pyloric feeding tube placement is limited. We conducted a meta-analysis to compare the performance of EM-guided versus endoscopic placement. Methods: We searched several databases for all randomised controlled trials evaluating the EM-guided vs. endoscopic placement of post-pyloric feeding tubes up to 28 July 2020. Primary outcome was procedure success rate. Secondary outcomes included reinsertion rate, number of attempts, placement-related complications, tuberelated complications, insertion time, total procedure time, patient discomfort, recommendation scores, length of hospital stay, mortality, and total costs. Results: Four trials involving 536 patients were qualified for the final analysis. There was no difference between the two groups in procedure success rate (RR 0.97; 95% CI 0.91–1.03), reinsertion rate (RR 0.84; 95% CI 0.59–1.20), number of attempts (WMD − 0.23; 95% CI − 0.99–0.53), placement-related complications (RR 0.78; 95% CI 0.41–1.49), tube-related complications (RR 1.08; 95% CI 0.82–1.44), total procedure time (WMD − 18.09 min; 95% CI − 38.66– 2.47), length of hospital stay (WMD 1.57 days; 95% CI − 0.33–3.47), ICU mortality (RR 0.80; 95% CI 0.50–1.29), inhospital mortality (RR 0.87; 95% CI 0.59–1.28), and total costs (SMD − 1.80; 95% CI − 3.96–0.36). The EM group was associated with longer insertion time (WMD 4.3 min; 95% CI 0.2–8.39), higher patient discomfort level (WMD 1.28; 95% CI 0.46–2.1), and higher recommendation scores (WMD 1.67; 95% CI 0.24–3.10). Conclusions: No significant difference was found between the two groups in efficacy, safety, and costs. Further studies are needed to confirm our findings. Systematic review registration: PROSPERO (CRD42020172427) Keywords: Electromagnetic, Endoscopy, Post-pyloric feeding tube, Enteral nutrition
* Correspondence: [email protected] † Yaping Wei and Zheng Jin contributed equally to this work. Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
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