Transcutaneous port for levodopa/carbidopa intestinal gel administration in Parkinson's disease
2016 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 133, no 3, 208-215 p.Article in journal (Refereed) Published
OBJECTIVE: To evaluate the safety and tolerability of the T-Port(®) for intestinal infusion of levodopa/carbidopa gel in patients with advanced Parkinson's disease (PD).
METHODS: This prospective study was carried out in 24 patients with PD (15 males, mean age 61.8 years, mean duration PD 18.7 years). All adverse device effects were evaluated at 2 weeks, 3 months and 6 months and until explantation or death.
RESULTS: Post-operative complications were similar to endoscopic gastrojejunostomy placement (four peritoneal irritation, one pocket pain). Eight patients with prior experience with the endoscopic gastrojejunostomy preferred the T-Port. The total device experience was 83.6 years, and the average survival time was 3.6 (range 1.1-5.2) years. Six T-Ports were still in use, and two patients had died due to non-device-related reasons. Sixteen T-Ports had been explanted due to 15 stoma reactions (14 inflammations and one infection) and one tilting of the T-Port. The T-Ports were replaced with endoscopic gastrojejunostomy system as replacements with T-Ports were not part of the study. Only two device malfunctions occurred (one catheter breakage at 3 year post-implant and one T-Port leakage of levodopa/carbidopa gel). No tube kinking, dislocation or blockage occurred. The number of adverse device effects proved to be significantly lower as compared to the endoscopic gastrojejunostomy literature data.
CONCLUSIONS: The T-Port is safe and well tolerated, and the low number of tube problems is a potential advantage compared with the endoscopic gastrojejunostomy system. Proper cleaning and local treatment of the stoma site around the T-Port are essential to prolong its longevity.
Place, publisher, year, edition, pages
2016. Vol. 133, no 3, 208-215 p.
clinical trial; levodopa/carbidopa infusion; Parkinson's disease; percutaneous endoscopic gastrojejunostomy; transcutaneous port
IdentifiersURN: urn:nbn:se:uu:diva-261204DOI: 10.1111/ane.12464ISI: 000371628100006PubMedID: 26213103OAI: oai:DiVA.org:uu-261204DiVA: diva2:850037
FunderSwedish Research CouncilVINNOVA