title: T-fastener migration after percutaneous gastropexy for transgastric enteral tube insertion.
abstract: OBJECTIVE
  To determine the prevalence and time-course of t-fastener migration after gastropexy deployment.
  
  
  METHODS
  We reviewed our procedural database for all percutaneous gastrostomy and gastrojejunostomy tube insertions performed over a 14-month period using a widely accepted t-fastener kit for gastropexy (Kimberly-Clark). Of 201 patients, 71 (41 males, 30 females; mean age, 56 years) underwent subsequent abdominal computed tomography (CT) imaging. The location and associated findings of each t-fastener were retrospectively recorded for each CT scan performed after the tube insertion.
  
  
  RESULTS
  A total of 153 t-fasteners were deployed during 71 procedures with subsequent CT follow-up. In the short term (within 4 weeks after deployment), 5.1% of the t-fasteners had detached and were no longer present; 59.5% were intraluminal or within the gastric wall; and 35.5% were within the anterior abdominal wall musculature or subcutaneous. In the long term (>3 months), 48.6% of the t-fasteners had detached and were no longer present, 25.0% were intraluminal or within the gastric wall, and 26.4% were within the anterior abdominal wall musculature or subcutaneous. No t-fastener-related complications, such as abscesses, fluid collections, or fistulae, were identified.
  
  
  CONCLUSIONS
  Following gastropexy for percutaneous transgastric feeding tube placement, t-fastener migration into the abdominal wall frequently occurred soon after the tube insertion. Therefore, recent t-fastener deployment does not guarantee an intact gastropexy.
authors.affiliation: Division of Vascular and Interventional Radiology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Ryan H
authors.initials: RH
authors.lastname: Sydnor
authors.affiliation: Division of Vascular and Interventional Radiology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Stacey M
authors.initials: SM
authors.lastname: Schriber
authors.affiliation: Division of Vascular and Interventional Radiology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Charles Yoon
authors.initials: CY
authors.lastname: Kim
mesh_terms: D034861:Abdominal Wall / Q000601:surgery; D004750:Enteral Nutrition; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications / Q000453:epidemiology*; D059485:Gastropexy / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D053831:Surgical Fixation Devices / Q000009:adverse effects; D013997:Time Factors
keywords: Gastrojejunostomy tube; Gastropexy; Gastrostomy tube; T-fasteners