Skip to main content

Advertisement

SpringerLink
Log in

Comparison of fluoroscopy-guided Pull-type Percutaneous Radiological Gastrostomy (Pull-type-PRG) with conventional Percutaneous Radiological Gastrostomy (Push-type-PRG): clinical results in 253 patients

  • Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To analyze the clinical results and complications of fluoroscopy guided internal-external Pull-type percutaneous radiological gastrostomy (Pull-type-PRG) and conventional external-internal percutaneous radiological gastrostomy (Push-type-PRG).

Methods

A total of 253 patients underwent radiological gastrostomy between January 2002 and January 2010. Data were collected retrospectively from radiology reports, Chart review of clinical notes, procedure reports, discharge summaries and subsequent hospital visits. Statistical analysis was performed to compare the two methods for gastrostomy with respect to peri-interventional aspects and clinical results.

Results

128 patients received the Pull-type-PRG whereas the other 125 patients were served with the Push-type-PRG. Indications for gastrostomy were similar in these two groups. The most frequent indications for the both methods were stenotic oesophageal tumors or head/neck tumors (54.7% in Pull-type-PRG, 68% in Push-type-PRG). Gastrostomy procedures were successful in 98.3% in Pull-type-PRG compared to 92% in Push-type-PRG. There was no procedure-related mortality. Compared to Push-type-PRG, the peri-interventional complication rate was significantly reduced in Pull-type-PRG (14.8% versus 34.4%, P = 0.002).

Conclusions

Compared to the external-internal Push-type-PRG, the internal-external Pull-type-PRG showed a high primary success rate and a decreased incidence of peri-interventional complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Wills JS, Oglesby JT (1983) Percutaneous gastrostomy. Radiology 149:449–453

    PubMed  CAS  Google Scholar 

  2. Ho CS (1983) Percutaneous gastrostomy for jejunal feeding. Radiology 149:595–596

    PubMed  CAS  Google Scholar 

  3. Ho CS, Yeung EY (1992) Percutaneous gastrostomy and transgastric jejunostomy. AJR Am J Roentgenol 158:251–257

    PubMed  CAS  Google Scholar 

  4. Halkier BK, Ho CS, Yee AC, Yee (1989) Percutaneous feeding gastrostomy with the Seldinger technique: review of 252 patients. Radiology 171:359–362

    PubMed  CAS  Google Scholar 

  5. Saini S et al (1990) Percutaneous gastrostomy with gastropexy: experience in 125 patients. AJR Am J Roentgenol 154:1003–1006

    PubMed  CAS  Google Scholar 

  6. Preshaw RM (1981) A percutaneous method for inserting a feeding gastrostomy tube. Surg Gynecol Obstet 152:658–660

    PubMed  CAS  Google Scholar 

  7. Sane SS et al (1998) Percutaneous gastrostomy tube placement in patients with ventriculoperitoneal shunts. Pediatr Radiol 28:521–523

    Article  PubMed  CAS  Google Scholar 

  8. Szymski GX et al (1997) Radiologically guided placement of pull-type gastrostomy tubes. Radiology 205:669–673

    PubMed  CAS  Google Scholar 

  9. Pitton MB, Herber S, Dueber C (2008) Fluoroscopy-guided pull-through gastrostomy. Cardiovasc Intervent Radiol 31:142–148

    Article  PubMed  CAS  Google Scholar 

  10. Towbin RB, Ball WS, Bissett GS (1998) Percutaneous gastrostomy and percutaneous gastrojejunostomy in children: antegrade approach. Radiology 168:473–476

    Google Scholar 

  11. Kuo YC et al (2008) Large or small bore, push or pull: a comparison of three classes of percutaneous fluoroscopic gastrostomy catheters. J Vasc Interv Radiol 19:557–563

    Article  PubMed  Google Scholar 

  12. Laasch HU, Martin DF (2007) Radiologic gastrostomy. Endoscopy 39:247–255

    Article  PubMed  Google Scholar 

  13. Gauderer MW, Ponsky JL, Izant RJ (1998) Gastrostomy without laparotomy: a percutaneous endoscopic technique. Nutrition 14:736–738

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  15. Stern JS (1986) Comparison of percutaneous endoscopic gastrostomy with surgical gastrostomy at a community hospital. Am J Gastroenterol 81:1171–1173

    PubMed  CAS  Google Scholar 

  16. Cosentini EP et al (1998) Outcomes of surgical, percutaneous endoscopic, and percutaneous radiologic gastrostomies. Arch Surg 133:1076–1083

    Article  PubMed  CAS  Google Scholar 

  17. Wollman B 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 

  18. Bell SD et al (1995) Percutaneous gastrostomy and gastrojejunostomy: additional experience in 519 procedures. Radiology 194:817–820

    PubMed  CAS  Google Scholar 

  19. de Baere T et al (1999) Percutaneous gastrostomy with fluoroscopic guidance: single- center experience in 500 consecutive cancer patients. Radiology 210:651–654

    PubMed  Google Scholar 

  20. Mildenberger P et al (1996) Radiologically assisted percutaneous gastro-/enterostomy–a retrospective analysis of 90 procedures. Rofo 165:74–79

    PubMed  CAS  Google Scholar 

  21. Dinkel HP et al (2002) Establishing radiological percutaneous gastrostomy with balloon- retained tubes as an alternative to endoscopic and surgical gastrostomy in patients with tumours of the head and neck or oesophagus. Br J Radiol 75:371–377

    PubMed  Google Scholar 

  22. Thornton FJ et al (2000) Percutaneous gastrostomy in patients who fail or are unsuitable for endoscopic gastrostomy. Cardiovasc Intervent Radiol 23:279–284

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  24. Deurloo EE et al (2001) Percutaneous radiological gastrostomy in patients with head and neck cancer. Eur J Surg Oncol 27:94–97

    Article  PubMed  CAS  Google Scholar 

  25. McLoughlin RF, So B, Gray RR (1996) Fluoroscopically guided percutaneous gastrostomy: current status. Can Assoc Radiol J 47:10–15

    PubMed  CAS  Google Scholar 

  26. Munk PL et al (1997) Percutaneous gastrostomy in radiological practice. Australas Radiol 41:342–350

    PubMed  CAS  Google Scholar 

  27. Walton GM (1999) Complications of percutaneous gastrostomy in patients with head and neck cancer–an analysis of 42 consecutive patients. Ann R Coll Surg Engl 81:272–276

    PubMed  CAS  Google Scholar 

  28. Qanadli SD et al (1999) Percutaneous gastrostomy for enteral nutrition: long-term follow-up of 176 procedures. Can Assoc Radiol J 50:260–264

    PubMed  CAS  Google Scholar 

  29. Neeff M et al (2003) Comparison of the use of endoscopic and radiologicl gastrostomy in a single head and neck cancer unit. ANZ J Surg 73:590–593

    Article  PubMed  Google Scholar 

  30. Ozmen MN, Akhan O (2002) Percutaneous radiologic gastrostomy. Eur J Radiol 43:186–195

    Article  PubMed  Google Scholar 

  31. Jain NK et al (1987) Antibiotic prophylaxis for percutaneous endoscopic gastrostomy. A prospective, randomized, double-blind clinical trial. Ann Intern Med 107:824–828

    PubMed  CAS  Google Scholar 

  32. Akkersdijk WL et al (1995) Percutaneous endoscopic gastrostomy: comparison of push and pull methods and evaluation of antibiotic prophylaxis. Endoscopy 27:313–316

    Article  PubMed  CAS  Google Scholar 

  33. Yip D, Vanasco M, Funaki B (2004) Complication rates and patency of radiologically guided mushroom gastrostomy, balloon gastrostomy, and gastrojejunostomy: a review of 250 procedures. Cardiovasc Intervent Radiol 27:3–8

    Article  PubMed  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  35. Dewald CL et al (1999) Percutaneous gastrostomy and gastrojejunostomy with gastropexy: experience in 701 procedures. Radiology 211:651–656

    PubMed  CAS  Google Scholar 

  36. Gottschalk A et al (2007) CT-guided percutaneous gastrostomy: success rate, early and late complications. Rofo 179:387–395

    PubMed  CAS  Google Scholar 

  37. Maccabee D, Sheppard BC (2003) Prevention of percutaneous endoscopic gastrostomy stoma metastases in patients with active oropharyngeal malignancy. Surg Endosc 17:1678

    Article  PubMed  CAS  Google Scholar 

  38. Cruz I et al (2005) Incidence of abdominal wall metastasis complicating PEG tube placement in untreated head and neck cancer. Gastrointest Endosc 62:708–711

    Article  PubMed  Google Scholar 

  39. Douglas JG, Koh W, Laramore GE (2000) Metastasis to a percutaneous gastrostomy site from head and neck cancer: radiobiologic considerations. Head Neck 22:826–830

    Article  PubMed  CAS  Google Scholar 

  40. Koscielny S et al (2001) Abdominal wall metastases as a complication of percutaneous endoscopic gastrostomy in carcinoma of the upper aerodigestive tract. Hno 49:392–395

    Article  PubMed  CAS  Google Scholar 

  41. Cappell MS (2007) Risk factors and risk reduction of malignant seeding of the percutaneous endoscopic gastrostomy track from pharyngoesophageal malignancy: a review of all 44 known reported cases. Am J Gastroenterol 102:1307–1311

    Article  PubMed  Google Scholar 

  42. Hawken RMA et al (2005) Puncture-site metastasis in a radiologically inserted gastrostomy tube: case report and literature review. Cardiovasc Intervent Radiol 28:377–380

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany

    Yang Yang, J. Schneider, C. Düber & M. B. Pitton

Authors
  1. Yang Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Schneider
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Düber
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. B. Pitton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yang Yang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yang, Y., Schneider, J., Düber, C. et al. Comparison of fluoroscopy-guided Pull-type Percutaneous Radiological Gastrostomy (Pull-type-PRG) with conventional Percutaneous Radiological Gastrostomy (Push-type-PRG): clinical results in 253 patients. Eur Radiol 21, 2354–2361 (2011). https://doi.org/10.1007/s00330-011-2194-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-011-2194-3

Keywords

Search

Navigation