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Reviewer Comment on Dallaire et al. “Mortality and Complications of Percutaneous Gastrostomy in Amyotrophic Lateral Sclerosis Patients”
Published online by Cambridge University Press: 23 February 2026
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- © The Author(s), 2026. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation
References
Dallaire, JS, Bachand, M-P, Shaul, J, Lareau-Trudel, E. “Mortalitiy and complications of percutaneous gastrostomy in amyotrophic lateral sclerosis patients.Google Scholar
Carbó Perseguer, J, Madejón Seiz, A, Romero Portales, M, Martínez Hernández, J, Mora Pardina, JS, García-Samaniego, J. La gastrostomía endoscópica percutánea en pacientes diagnosticados de esclerosis lateral amiotrófica: mortalidad y complicaciones. Neurologia. 2019;34(9):582–8. DOI: 10.1016/j.nrl.2018.01.003.CrossRefGoogle Scholar
Mathus-Vliegen, LMH, Louwerse, LS,Merkus, MP,Tytgat, GNJ,Vianney de Jong, JMB. Percutaneous endoscopic gastrostomy in patients with amyotrophic lateral sclerosis and impaired pulmonary function. Gastrointest Endosc. 1994;40(4):463–9.CrossRefGoogle ScholarPubMed
Lung, BE, Bisogno, M, Kanjiya, S, Komatsu, DE,Wang, ED. Early postoperative complications and discharge time in diabetic patients undergoing total shoulder arthroplasty. J Orthop Surg Res. 2019;14(1):9. DOI: 10.1186/s13018-018-1051-3.CrossRefGoogle ScholarPubMed
Xu, C, Yang, Z-Q, Liu, S, Yang, W, Shi, H-B, Zhou, W-Z. Percutaneous radiologic gastrostomy in patients with amyotrophic lateral sclerosis: a safe and effective technique. Int J Gastrointest Interv. 2021;10(2):72–6.CrossRefGoogle Scholar
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The published article Reference Dallaire, Bachand, Shaul and Lareau-Trudel1 is a retrospective study that examines and compares mortality and complications in a cohort of patients who underwent either endoscopic gastrostomy or radiologic gastrostomy between 2010 and 2023. The authors investigate predictive factors for adverse events. Their results show a mortality rate of 9.3% and a severe complication rate of 16.7%, which is at the upper limit of what has been reported in other series. Reference Carbó Perseguer, Madejón Seiz, Romero Portales, Martínez Hernández, Mora Pardina and García-Samaniego2 The authors acknowledge that this may be due to the small sample size of their study and to the broad definition of severe adverse events.
The association between pre-existing pulmonary disease and hypercapnia with adverse events after percutaneous gastrostomy is consistent with previously published studies. Reference Mathus-Vliegen, Louwerse, Merkus, Tytgat and Vianney de Jong3 The fact that slow vital capacity did not emerge as a significant predictive factor is likely related to the fact that 30% of patients did not have this variable measured, introducing a potential bias.
Diabetes was identified as a potential predictive factor, although it did not reach statistical significance. This finding is consistent with previously published data on the influence of diabetes on postoperative complications. Reference Lung, Bisogno, Kanjiya, Komatsu and Wang4
Finally, the authors did not observe differences in mortality or complications between endoscopic percutaneous gastrostomy and radiologic gastrostomy, in line with other studies Reference Xu, Yang, Liu, Yang, Shi and Zhou5 – although they acknowledge that the most fragile patients tended to undergo radiologic gastrostomy.
In conclusion, this paper deserves recognition as one of the few published studies comparing mortality and complications between these two types of gastrostomy. It also suggests that diabetes may be a probable predictive factor for complications.
Competing interests
The author declares that he has no conflicts of interest.