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Insertion of Balloon Retained Gastrostomy Buttons: A 5-Year Retrospective Review of 260 Patients

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Abstract

Purpose

Radiologically inserted gastrostomy (RIG) is an established way of maintaining enteral nutrition in patients who cannot maintain nutrition orally. The purpose of this study was to evaluate the safety and efficacy of primary placement of a wide bore button gastrostomy in a large, varied patient population through retrospective review.

Methods

All patients who underwent gastrostomy placement from January 1, 2004 to January 1, 2009 were identified. 18-Fr gastrostomy buttons (MIC-Key G) were inserted in the majority. Follow-up ranged from 6 months to 4.5 years.

Results

A total of 260 patients (M:F 140:120, average age 59.2 years) underwent gastrostomy during the study period. Overall success rate for RIG placement was 99.6 %, with success rate of 95.3 % for primary button insertion. Indications included neurological disorders (70 %), esophageal/head and neck malignancy (21 %), and other indications (9 %). Major and minor complication rates were 1.2 and 12.8 %, respectively. Thirty-day mortality rate was 6.8 %. One third of patients underwent gastrostomy reinsertion during the study period, the main indication for which was inadvertent catheter removal. Patency rate was high at 99.5 %. The maximum number of procedures in any patient was 8 (n = 2), and the average tube dwell time was 125 days.

Conclusions

Primary radiological insertion of a wide bore button gastrostomy is a safe technique, with high success rate, high patency rate, and low major complication rate. We believe that it is feasible to attempt button gastrostomy placement in all patients, once tract length is within limits of tube length. If difficulty is encountered, then a standard tube may simply be placed instead.

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References

  1. Wollman B, D’Agostino H, Walus-Wigle J et al (1995) Radiologic, endoscopic, and surgical gastrostomy: an institutional evaluation and meta-analysis of the literature. Radiology 197:699–704

    PubMed  CAS  Google Scholar 

  2. Cosentini E, Sautner T, Gnant M et al (1998) Outcomes of surgical, percutaneous endoscopic, and percutaneous radiologic gastrostomies. Arch Surg 133:1076–1083

    Article  PubMed  CAS  Google Scholar 

  3. Gauderer M, Ponsky J (1980) Gastrostomy without laparoscopy: a percutaneous endoscopic technique. J Pediatr Surg 15:872–875

    Article  PubMed  CAS  Google Scholar 

  4. Preshaw R (1981) A percutaneous method for inserting a feeding gastrostomy tube. Surg Gynecol Obstet 152:659–660

    Google Scholar 

  5. Thornton F, Fotheringham T, Alexander M et al (2002) Amyotrophic lateral sclerosis: enteral nutrition provision-endoscopic or radiologic gastrostomy? Radiology 224(3):713–717

    Article  PubMed  Google Scholar 

  6. Galaski A, Peng W, Ellis M et al (2009) Gastrostomy tube placement by radiological versus endoscopic methods in an acute care setting: a retrospective review of frequency, indications, complications and outcomes. Can J Gastroenterol 23(2):109–114

    PubMed  Google Scholar 

  7. Rio A, Ampong M, Turner M et al (2005) Comparison of two percutaneous radiological gastrostomy tubes in the nutritional management of ALS patients. Amyotroph Lateral Scler Other Motor Neuron Disord 6(3):177–181

    Article  PubMed  Google Scholar 

  8. de Baere T, Chapot R, Kuoch V et al (1999) Percutaneous gastrostomy with fluoroscopic guidance: single-center experience in 500 consecutive cancer patients. Radiology 210(3):651–654

    PubMed  Google Scholar 

  9. Quadri A, Umapathy N, Orme R (2005) Percutaneous gastrostomy in patients with complete obstruction of the upper digestive tract. Eur J Radiol 56:74–77

    Article  PubMed  CAS  Google Scholar 

  10. Funaki B, Zaleski G, Lorenz J et al (2000) Radiologic gastrostomy placement: pigtail-versus mushroom retained catheters. AJR Am J Roentgenol 175:375–379

    Article  PubMed  CAS  Google Scholar 

  11. Lyon S, Haslam P, Duke D et al (2003) De novo placement of button gastrostomy catheters in an adult population: experience in 53 patients. J Vasc Interv Radiol 14:1283–1289

    Article  PubMed  Google Scholar 

  12. Neeff M, Crowder V, McIvor N et al (2003) Comparison of the use of endoscopic and radiologic gastrostomy in a single head and neck cancer unit. ANZ J Surg 73(8):590–593

    Article  PubMed  Google Scholar 

  13. Funaki B, Peirce R, Lorenz J et al (2001) Comparison of balloon- and mushroom-retained large-bore gastrostomy catheters. AJR Am J Roentgenol 177(2):359–362

    Article  PubMed  CAS  Google Scholar 

  14. Given M, Hanson J, Lee M (2005) Interventional radiology techniques for provision of enteral feeding. Cardiovasc Intervent Radiol 28(6):692–703

    Article  PubMed  CAS  Google Scholar 

  15. Foster A, Given M, Thornton E et al (2009) Removal of T-fasteners 2 days after gastrostomy is feasible. Cardiovasc Intervent Radiol 32:317–319

    Article  PubMed  CAS  Google Scholar 

  16. Shaw A, Ampong M, Rio A et al (2004) EntriStar skin-level gastrostomy tube: primary placement with radiologic guidance in patients with amyotrophic lateral sclerosis. Radiology 233:392–399

    Article  PubMed  Google Scholar 

  17. Lewis D, Ampong M, Rio A et al (2009) Mushroom-cage gastrostomy tube placement in patients with amyotrophic lateral sclerosis: a 5-year experience in 104 patients in a single institution. Eur Radiol 19(7):1763–1771

    Article  PubMed  Google Scholar 

  18. Thornton F, Fotheringham T, Haslam P et al (2002) Percutaneous radiologic gastrostomy with and without T-fastener gastropexy: a randomized comparison study. Cardiovasc Intervent Radiol 25:467–471

    Article  PubMed  CAS  Google Scholar 

  19. Shin J, Song H, Kim T et al (2008) Percutaneous radiologic gastrostomy: a modified chiba-needle puncture technique with single gastropexy. Abdom Imaging 35(2):189–194

    Article  Google Scholar 

  20. Lorentzen T, Nolsøe C, Adamsen S (2007) Percutaneous radiologic gastrostomy with a simplified gastropexy technique under ultrasonographic and fluoroscopic guidance: experience in 154 patients. Acta Radiol 48(1):13–19

    Article  PubMed  CAS  Google Scholar 

  21. Ryan J, Hahn P, Boland G et al (1997) Percutaneous gastrostomy with T-fastener gastropexy: results of 316 consecutive procedures. Radiology 203(2):496–500

    PubMed  CAS  Google Scholar 

  22. Tsukuda T, Fujita T, Ito K et al (2006) Percutaneous radiologic gastrostomy using push-type gastrostomy tubes with CT and fluoroscopic guidance. AJR Am J Roentgenol 186(2):574–576

    Article  PubMed  Google Scholar 

  23. Cantwell C, Perumpillichira J, Maher M et al (2008) Antibiotic prophylaxis for percutaneous radiologic gastrostomy and gastrojejunostomy insertion in outpatients with head and neck cancer. J Vasc Interv Radiol 19(4):571–575

    Article  PubMed  Google Scholar 

  24. Silas A, Pearce L, Lestina L et al (2005) Percutaneous radiologic gastrostomy versus percutaneous endoscopic gastrostomy: a comparison of indications, complications and outcomes in 370 patients. Eur J Radiol 56(1):84–90

    Article  PubMed  Google Scholar 

  25. Longcroft-Wheaton G, Marden P, Colleypriest B et al (2009) Understanding why patients die after gastrostomy tube insertion: a retrospective analysis of mortality. JPEN J Parenter Enteral Nutr 33(4):375–379

    Article  PubMed  Google Scholar 

  26. Abuksis G, Mor M, Segal N et al (2000) Percutaneous endoscopic gastrostomy: high mortality rates in hospitalized patients. Am J Gastroenterol 95(1):128–132

    Article  PubMed  CAS  Google Scholar 

  27. Dharmarajan T, Unnikrishnan D, Pitchumoni C (2001) Percutaneous endoscopic gastrostomy and outcome in dementia. Am J Gastroenterol 96(9):2556–2563

    Article  PubMed  CAS  Google Scholar 

  28. Stroud M, Duncan H, Nightingale J (2003) Guidelines for enteral feeding in adult hospital patients. Gut 52(Suppl VII):vii1–vii12

    PubMed  Google Scholar 

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Conflict of interest

The authors declare no conflict of interest

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Authors and Affiliations

  1. Department of Radiology, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland

    Sarah Power, Liam N. Kavanagh, Mary C. Shields, Mark F. Given, Aoife N. Keeling, Frank P. McGrath & Michael J. Lee

Authors
  1. Sarah Power
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  2. Liam N. Kavanagh
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  3. Mary C. Shields
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  4. Mark F. Given
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  5. Aoife N. Keeling
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  6. Frank P. McGrath
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  7. Michael J. Lee
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Corresponding author

Correspondence to Michael J. Lee.

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Power, S., Kavanagh, L.N., Shields, M.C. et al. Insertion of Balloon Retained Gastrostomy Buttons: A 5-Year Retrospective Review of 260 Patients. Cardiovasc Intervent Radiol 36, 484–491 (2013). https://doi.org/10.1007/s00270-012-0456-3

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  • DOI: https://doi.org/10.1007/s00270-012-0456-3

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