Usefulness of percutaneous endoscopic gastrostomy for supportive therapy of advanced aerodigestive cancer

Table 1 Comparison of the advantages and disadvantages of the pull, introducer and direct percutaneous endoscopic gastrostomy placement methods

	Advantages	Disadvantages
Pull method	Bumper type device inside stomach prevents misplacement of catheter Large-bore catheters can be used immediately after placement	Catheter may be contaminated during passage through mouth/esophagus → Increased risk of wound infection and tumor implantation Endoscope must be inserted twice to confirm correct placement
Introducer method	Adherence to aseptic technique guarantees low risk of wound infection Endoscope must be inserted only once	Risk of bleeding and incorrect puncture with large trocar Only small-lumen catheters can be used immediately after placement Catheter size must be increased step by step High probability of catheter misplacement (if using balloon type)
Direct PEG Kit	Adherence to aseptic technique guarantees low risk of wound infection Endoscope must be inserted only once Small puncture needle and blunt dilator → small wound One-step insertion of bumper type device Large-bore catheters can be used immediately after placement	Risk of bleeding

PEG: Percutaneous endoscopic gastrostomy.