Retrospective comparison of outcomes and associated complications between large bore radiologically inserted gastrostomy tube types

• Published in: Abdominal imaging 2019-01, Vol.44 (1), p.318-326
• Main Authors: Tischfield, David J., Nadolski, Gregory J., Hunt, Stephen J., Itkin, Maxim, Shlansky-Goldberg, Richard D., Gade, Terence P.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Balloon treatment; BALLOONS; BIOMEDICAL RADIOGRAPHY; Boring tools; Catheters; Complications; Databases, Factual; Electronic devices; Electronic health records; Electronic medical records; Equipment Design; Female; Gastroenterology; Gastrostomy - instrumentation; Gastrostomy - methods; Hepatology; Humans; Imaging; Male; MEDICAL RECORDS; Medicine; Medicine & Public Health; Middle Aged; Ostomy; PATIENTS; Postoperative Complications - epidemiology; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Radiology, Interventional - methods; Retrospective Studies; Statistical analysis; Young Adult
• ISSN: 2366-004X; 2366-0058; 2366-0058
• DOI: 10.1007/s00261-018-1717-7

Purpose Multiple approaches to radiologically inserted gastrostomy (RIG) exist. The goal of this study was to compare 30-day outcomes and associated complications between large bore balloon-retained (BR), loop-retained (LR), and pull-type (PT) RIG devices. Methods Data on 1477 patients who underwent RIG between January 1, 2005 and December 31, 2016 were collected retrospectively using a dedicated interventional radiology database and electronic medical record. Statistical analysis was performed to compare complication rates between BR, LR, and PT devices. Results Ninety-eight percent (1477/1507) of the procedures were successfully performed. A total of 752 BR, 323 LR, and 402 PT gastrostomy tubes were placed. The overall complication rate for BR catheters was 5.7% (25 major [3.3%] and 18 minor [2.4%]). The overall complication rate for PT catheters was 3.7% (8 major [2.0%] and 7 minor [1.7%]). The overall complication rate for LR catheters was 1.6% (4 major [1.4%] and 1 minor [0.8%]). Compared to BR catheters, LR catheters had significantly fewer total complications ( P  = 0.01) but not minor complications ( P  = 0.052). There were no significant differences in the number of complications between LR and PT catheters or between BR and PT catheters. Conclusions Use of BR, LR, and PT devices for RIG is safe with a low incidence of complications. Compared to BR catheters, primary insertion of a LR gastrostomy was associated with significantly fewer overall complications within the first 30 days. Therefore, for initial tube placement, large bore LR catheters may be preferred over BR devices.