title: Comparison of two percutaneous radiological gastrostomy tubes in the nutritional management of ALS patients.
abstract: Patient care and minimizing complications post gastrostomy have to date received little attention in ALS patients. We compare the complications associated with pigtail and mushroom type percutaneous radiological gastrostomy tubes in this patient group. Patients requiring PRG received either Wills-Oglesby or the skin level Entristar. Retrospective review of the clinical notes was performed capturing demographic data, peristomal infection, tube displacement, tube failure, nutritional status, site of disease onset, and survival. Thirty-five patients (Group 1) had the Wills-Oglesby tube of which 14 (40%) tubes required replacement. The Entristar tube was inserted in 29 patients (Group 2) where 8 (28%) required replacement (NS). The incidence of infection was significantly lower with the Entristar tube, (p<0.001). The mean time to tube removal in Group 2 was 223 days (SD 147; range 71-494 days) due to 'buried bumper syndrome'. We conclude that the Entristar skin level gastrostomy tube is associated with a reduction in peristomal infection, tube failure and blockage compared with the Wills-Oglesby tube.
authors.affiliation: Department of Nutrition and Dietetics, King's College Hospital, London, UK. alan.rio@kingsch.nhs.uk
authors.forename: Alan
authors.initials: A
authors.lastname: Rio
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Ampong
authors.forename: Martin R
authors.initials: MR
authors.lastname: Turner
authors.forename: Ashley S
authors.initials: AS
authors.lastname: Shaw
authors.forename: Ammar
authors.initials: A
authors.lastname: Al-Chalabi
authors.forename: Chris E
authors.initials: CE
authors.lastname: Shaw
authors.forename: P Nigel
authors.initials: PN
authors.lastname: Leigh
authors.forename: Paul S
authors.initials: PS
authors.lastname: Sidhu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000628:therapy*; D004750:Enteral Nutrition; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011029:Pneumoradiography / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014894:Weights and Measures