Comparison of Foley catheter as a replacement gastrostomy tube with commercial replacement gastrostomy tube: a prospective randomized trial.
Percutaneous endoscopic gastrostomy (PEG) provides a non-surgical alternative to long-term enteral feeding. The gastrostomy tube, however, may deteriorate, malfunction, or be accidentally expelled, requiring replacement. A commercial gastrostomy tube is commonly used for replacement. However, a commercial replacement gastrostomy tube is many times more expensive than a Foley catheter, and the two have never been compared. We compared the efficacy and safety of an all-silicone Foley catheter used as a replacement feeding gastrostomy tube with the effectiveness of a commercial replacement gastrostomy tube in 46 patients undergoing long-term enteral feedings per gastrostomy. Twenty-four patients were randomized to the Foley group and 22 patients to the commercial replacement gastrostomy tube group. The Foley catheter functioned well without need for replacement in 16 (66%) patients for 27.4 +/- 14.8 (mean +/- SD) weeks; the commercial replacement gastrostomy tube functioned in 13 (59%) patients for 24.5 +/- 13.6 weeks (p > 0.05, NS). The Foley catheter needed to be replaced because of malfunction in 8 (34%) patients and the commercial replacement gastrostomy tube in 9 (41%) patients after 21.6 +/- 11.5 weeks and 19.3 +/- 9.3 weeks, respectively (p > 0.05, NS). Neither the Foley catheter nor the commercial replacement gastrostomy tube migrated; this was the most striking finding, in contrast to case reports in the literature. Our data suggest that the Foley catheter can be safely used as a replacement gastrostomy tube; it is considerably cheaper than the commercial replacement gastrostomy tube, and its efficacy and complication rates are similar to those of the commercial replacement gastrostomy tube.
Gastroenterology Service, Brooke Army Medical Center, San Antonio, Texas 78234-6200.
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Kadakia
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Cassaday
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Shaffer
D002408:Catheters, Indwelling; D003365:Costs and Cost Analysis; D004750:Enteral Nutrition / Q000295:instrumentation*; D005260:Female; D005774:Gastrostomy / Q000191:economics / Q000295:instrumentation*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000191:economics / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors