Radiologically inserted gastrostomy: differences of maintenance of balloon- vs. loop-retained devices.
OBJECTIVE
To compare outcome and associated complications of ballon- vs. loop-retained devices for radiologically inserted gastrostomy (RIG).


METHODS
From 2007 to 2011 233 patients (age 63.7 ± 10.6 years) were referred for a RIG because of pharyngeal stricture Intervention was performed with four different devices: balloon-retained - Freka®GastroTube, Fresenius Kabi (n = 121); MIC®Gastrostomy Feeding Tube, Kimberly-Clark (n = 34); Russell®Gastrostomy Tray, Cook Medical Inc. (n = 17); and loop-retained - Tilma®Gastrostomy Set, Cook Medical Inc. (n = 50). Follow-up was performed with regard to RIG-related complications, cause of removal and fatalities. Revision-free survival times after RIG were evaluated using Kaplan-Meier analysis and group differences by log-rank tests. For analysis of demographic and methodical variables multivariate Cox regression models were used.


RESULTS
With a primary technical success rate of 95.3% (222/233) a total of 92 instances of revisions were necessary in 66 patients (66/233, 28.3%) during follow-up (mean 182.8 ± 86.6 days). The most common complication was tube dislodgement (14.3%). There were no significant differences between the distinct devices (p = 0.098), but analyzing the data in subgroups of balloon-compared to loop-retained gastrostomy tubes we observed a significantly higher probability of minor complications for the latter (p = 0.023).


CONCLUSIONS
As it is significantly less prone to minor complications we recommend the use of balloon-retained gastrostomy tubes to improve the practicability and maintenance of RIG.
a Department of Diagnostic and Interventional Radiology and Nuclear Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.|b Department of Diagnostic and Interventional Radiology and Nuclear Medicine , Section of Pediatric Radiology, University Medical Center Hamburg-Eppendorf , Hamburg , Germany.
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JD
Busch
a Department of Diagnostic and Interventional Radiology and Nuclear Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.|b Department of Diagnostic and Interventional Radiology and Nuclear Medicine , Section of Pediatric Radiology, University Medical Center Hamburg-Eppendorf , Hamburg , Germany.
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J
Herrmann
a Department of Diagnostic and Interventional Radiology and Nuclear Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany.
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G
Adam
c Catholic Marienkrankenhaus GmbH , Institute of Diagnostic and Interventional Radiology , Hamburg , Germany.
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CR
Habermann
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000009:adverse effects* / Q000295:instrumentation; D004750:Enteral Nutrition; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005774:Gastrostomy / Q000295:instrumentation*; D005858:Germany; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D015641:Radiography, Interventional; D012189:Retrospective Studies; D054047:Surgical Stomas; D055815:Young Adult
Nutrition; percutaneous gastrostomy; pharyngeal stricture