Faculty Collaboration Database

Radiologic versus Endoscopic Placement of Gastrostomy Tube: Comparison of Indications and Outcomes at a Tertiary Referral Center. South Med J 2019 Jan;112(1):39-44

Date

01/05/2019

Pubmed ID

30608631

DOI

10.14423/SMJ.0000000000000916

Scopus ID

2-s2.0-85059486517 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

OBJECTIVES: Percutaneous gastrostomy tube placement is performed in patients requiring long-term enteral nutrition. Although both endoscopic and fluoroscopic techniques may be used, there are inherent risks and potential complications associated with both procedures that are not generally known to referring physicians. The purpose of this study was to compare and contrast indications for placement and procedurally related complications between fluoroscopic and endoscopic gastrostomy tubes techniques at a tertiary care facility.

METHODS: A retrospective cohort study was performed. All consecutive patients with either percutaneous endoscopic (PEG) or percutaneous radiologic (PRG) gastrostomy tube placement between October 2011 and January 2013 were eligible for inclusion. Basic demographic information, American Society of Anesthesiologists score, procedure indication, laboratory data, and use of anticoagulation were recorded. Both direct and indirect procedural complications were documented if they occurred 30 days after gastrostomy tube placement, and were classified and scored based on severity and need for further intervention.

RESULTS: A total of 297 patients met the inclusion criteria, 150 of whom had gastrostomy tubes placed fluoroscopically and 147 of whom had them placed endoscopically. There was no statistically significant difference in direct complications within the first 30 days (PEG 6.8% vs PRG 8%); however, the type of complication observed varied between the two groups. Although superficial wound infections and buried bumpers were more common in the PEG group, bleeding was more common in the PRG group.

CONCLUSIONS: Placement of gastrostomy tubes either endoscopically or fluoroscopically is relatively safe with similar indications. Although the complication rate between the two groups was not significant, the types of procedural complications observed did vary.

Author List

Clayton S, DeClue C, Lewis T, Rodriguez A, Kolkhorst K, Syed R, Kumar A, Davis C, Brady P

Author

Carley Davis MD Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Enteral Nutrition
Female
Fluoroscopy
Gastroscopy
Gastrostomy
Humans
Male
Middle Aged
Postoperative Complications
Postoperative Hemorrhage
Retrospective Studies
Surgical Wound Infection
Tertiary Care Centers