Complications of percutaneous endoscopic and fluoroscopic gastrostomy tube insertion procedures in 378 patients.
Gastrostomy tubes are used for primary and supplemental feeding and gastric decompression. The purpose of the study was to compare the complication rate of gastrostomy tube placement by either endoscopic or fluoroscopic technique. Between 1996 and 2004, the surgical and radiological services at a Level I trauma hospital placed gastrostomy tubes in 378 patients (endoscopy=268, fluoroscopy=110). The percutaneous gastrostomy group comprised 71% of the cohort with a mean age of 51+/-21 (range: 1-93 years of age), and the percutaneous radiographic gastrostomy group comprised the remaining cohort (29%) with a mean age of 57+/-19 (range: 17-95 years of age). Fifty-eight percent of the percutaneous gastrostomy group were female (n=155) and 42% were male (n=113), whereas the gender distribution for the percutaneous radiographic gastrostomy group was 33% female (n=36) and 67% male (n=74). There was an overall complication rate of 36% (22% and 70% for the endoscopic and fluoroscopic methods, respectively). The most frequent complication in both types of techniques was tube dislodgement (endoscopic=32% [19/268]; fluoroscopic=27% [21/110]). There were very few serious complications. Women had a higher rate of postprocedure complications than did men, at 35% versus 27%. We conclude that gastrostomy tube placement by either endoscopic or fluoroscopic methods results in a number of complications, though most of them are minor. Patients must therefore be informed that this is not a complication-free procedure.
MacLean
Alexandra A
AA
New York Hospital of Queens, Weill Medical School, Cornell University, New York 11355, USA. aam9006@nyp.org
Alvarez
Nicolas R
NR
Davies
Jennifer D
JD
Lopez
Peter P
PP
Pizano
Louis R
LR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000209:etiology; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects* / Q000706:statistics & numerical data; D005773:Gastroscopy / Q000009:adverse effects* / Q000706:statistics & numerical data; D005774:Gastrostomy / Q000009:adverse effects* / Q000706:statistics & numerical data; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007223:Infant; D007441:Intubation, Gastrointestinal / Q000009:adverse effects* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D018579:Patient Selection; D010538:Peritonitis / Q000209:etiology; D011027:Pneumoperitoneum / Q000209:etiology; D012189:Retrospective Studies; D014193:Trauma Centers