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oai:repisalud.isciii.es:20.500.12105/226492024-11-28T19:45:25Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967

00925njm 22002777a 4500 dc Garrido-Duran, Carmen author Khorrami Minaei, Sam author Sendra Rumbeu, Pau author Fernández García, Joaquín author Garcia Hernandez, Marcelo author Legarda, Inés author 2019 Background: treatment of intraduodenal levodopa using percutaneous endoscopic gastrostomy is an alternative therapy in patients with advanced Parkinson's disease. There are few studies that have evaluated the endoscopic aspects of this technique. Objectives: to describe our experience and adverse events regarding this technique in advanced Parkinson's disease. Method: a retrospective study was performed from January 2007 to January 2019 in a tertiary healthcare center. Results: thirty-seven patients aged 65.1 +/- 10.3 years were included in the study, 21 were male and the disease duration was ten years (1-26). The median follow-up was 16 months (1-144). The device was successfully placed in all cases.The persistence rate with the PEG-D at the end of follow-up was 62.2%.The system was removed in 14 patients, seven due to neurological impairment, four because of the decision of the patient and three due to related events. Fifty-nine adverse events occurred in 23 patients (62.2%, 0.63 per patient-year), four of which were severe (8.1%, 0.05 per patient-year). Minor adverse events included 14 (37.8%) related to the stoma, six (16.2%) to the gastric tube and 15 (40.5%) to the duodenal tube. Forty-four system replacements were performed in 20 patients (54.1%, 0.52 per patient-year). Male sex, age over 70 and a higher comorbidity index were associated with a greater likelihood of persistence of the system (OR: 0.14, 95% CI: 0.03-0.62; OR: 0.52, 95% CI: 0.32-0.86; OR: 0.16, 95% CI: 0.03-0.99, respectively). No predictors of adverse events associated with PEG-D were identified. Conclusions: percutaneous endoscopic gastrostomy for the continuous delivery of duodenal levodopa is a highly effective technique. Adverse events are common, although most are resolved by endoscopy. Garrido Duran Carmen, Khorrami Minaei Sam, Sendra Rumbeu Pau, Fernandez Garcia Joaquin, Garcia Hernandez Marcelo, Legarda Ramírez Inés. Endoscopic management of duodenal levodopa-carbidopa therapy of advanced Parkinson's disease. Rev Esp Enferm Dig. 2019;111(11):828-832. 1130-0108 http://hdl.handle.net/20.500.13003/8922 https://hdl.handle.net/20.500.12105/22649 31566412 10.17235/reed.2019.6311/2019 2340-4167 Revista Española de Enfermedades Digestivas 2-s2.0-85074875039 495889800003 L629460158 Parkinson's disease Levodopa Percutaneous endoscopic gastrostomy Continuous enteral infusion Endoscopic management of duodenal levodopa-carbidopa therapy of advanced Parkinson's disease