Transcutaneous port for levodopa/carbidopa intestinal gel administration in Parkinson's disease

T. van Laar, D. Nyholm, R. Nyman*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)

Abstract

Objective - To evaluate the safety and tolerability of the T-Port (R) 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 1.15.2) 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.

Original languageEnglish
Pages (from-to)208-215
Number of pages8
JournalActa neurologica Scandinavica
Volume133
Issue number3
Early online date24-Jul-2015
DOIs
Publication statusPublished - Mar-2016

Keywords

  • clinical trial
  • levodopa/carbidopa infusion
  • Parkinson's disease
  • percutaneous endoscopic gastrojejunostomy
  • transcutaneous port
  • DUODENAL LEVODOPA INFUSION
  • TITANIUM IMPLANTS

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