Percutaneous radiologic gastrostomy. When, how, why – review of our experience in 64 patients

GIANNONI, A.
STURLESE, L.
TRABUCCHI, A.
TORRI, T.
SANGUINETTI, F.
PUCCIANTI, F.

¹Nutritional Support Team LHU1 Massa Carrara, Tuscany – Italy
²O.U. Anaesthesia and Resuscitation, Carrara Hospital, Tuscany – Italy
³O.U. Radiology, Carrara Hospital, Tuscany – Italy

Address for correspondence: Dr. Antonello Giannoni Team Nutrizionale e Servizio di Nutrizione Artificiale Domiciliare Regione Toscana, ASL1 di Massa Carrara, PO di Carrara Piazza Sacco e Vanzetti, 1 54033 Carrara, Italy e-mail: [email protected]; [email protected]

Received: May 8, 2006

Accepted: September 11, 2006

Nutritional Therapy & Metabolism 24(4):p 203-209, 2006.

ABSTRACT:

Aim.

To evaluate retrospectively the use of percutaneous radiologic gastrostomy (PRG) in dysphagic patients when percutaneous endoscopic gastrostomy (PEG) could not be safely employed (because of stenosis or bleeding risk due to esophagus or head and neck cancer, trismus, trauma or impaired respiratory function from amyotrophic lateral sclerosis [ALS] or chronic obstructive pulmonary disease [COPD]).

Materials and methods.

Since 1997, sixty-four consecutive patients (51 men, 13 women; mean age 67 years, range 47-84 years) have undergone PRG placement with T-fastener gastropexy under local anesthesia. The gastrostomy method, success rate of the technique, complications and 30-day mortality rate after PRG were reviewed. Some of the differences between PEG and PRG were also evaluated.

Results.

All the 64 procedures were successfully performed (100%), and no technique-related complications were observed. In patients followed up, 11,512 days of home enteral nutrition (HEN) (median 109 days, range 9-1,425 days) were provided; a survival less than 30 days was recorded in only 3 patients (6.5%). Only 1 minor complication in 1 patient (local wound infection and peristomal leakage) and 1 major complication (gastrocolic fistula not requiring surgical intervention) were recorded.

Conclusions.

PRG placement seems to be safe, simple and effective when PEG is difficult or impossible; it is a valid alternative to surgical gastrostomy.