Radiologic, endoscopic, and surgical gastrostomy: an institutional evaluation and meta-analysis of the literature.
OBJECTIVE
To evaluate the effectiveness and safety of radiologic, percutaneous endoscopic (PEG), and surgical gastrostomy.


METHODS
This project involved 5,752 patients (837 patients underwent radiologic gastrotomy; 4,194, PEG; and 721, surgical gastrostomy). Seventy-two (47 male, 25 female; age range, 12-94 years) underwent gastrostomy within 1 year in this series (radiologic gastrostomy, n = 33; PEG, n = 35; surgical gastrostomy, n = 4). A meta-analysis of 5,680 additional cases from literature published from 1980 to the present was also performed.


RESULTS
Rates of successful tube placement were higher for radiologic gastrostomy than for PEG in our series and in the meta-analysis (99.2% vs 95.7%, P < .001). Major complications occurred less frequently after radiologic gastrostomy in our series and in the meta-analysis (5.9% vs 9.4% for PEG and 19.9% for surgery, P < .001). Thirty-day procedure-related mortality rates were highest for surgery (2.5% vs 0.3% for radiologic gastrostomy and 0.53% for PEG, P < .001).


CONCLUSIONS
Radiologic gastrostomy is associated with a higher success rate than is PEG and less morbidity than either PEG or surgery.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D002648:Child; D016292:Procedural Sedation; D003365:Costs and Cost Analysis; D004750:Enteral Nutrition / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005773:Gastroscopy / Q000009:adverse effects / Q000191:economics / Q000379:methods; D005774:Gastrostomy / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D015642:Radiology, Interventional / Q000191:economics / Q000379:methods; D018570:Risk Assessment; D012449:Safety; D015996:Survival Rate; D013997:Time Factors