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[CT-guided percutaneous gastrostomy: success rate, early and late complications].
Rofo. 2007 Apr; 179(4):387-95.ROFO

Abstract

PURPOSE

Percutaneous endoscopic gastrostomy (PEG) and percutaneous radiologic gastrostomy (PRG) are the standard methods of ensuring long-term enteral food intake in patients with dysphagia caused by neoplasia or neurological disorders. High-grade obstructions of the upper digestive tract or inadequate transillumination can prevent PEG. CT-guided percutaneous gastrostomy (PG) represents a special technique for enabling gastrostomy in patients for whom the endoscopic method is impossible. The aim of this study was to evaluate the results and complications of CT-guided percutaneous gastrostomy.

MATERIALS AND METHODS

CT-guided PG was performed in 83 patients, mostly with malignancy of the upper respiratory or digestive tract. Medical records for these patients were reviewed, and the results and complications of the CT-guided PG were analyzed retrospectively. Complications were grouped into four categories: Major and minor complications as well as early and late complications.

RESULTS

In 95.2 % of all cases (79/83), CT-guided PG was successful in the first attempt. Within the first 3 days, 5 major complications including 4 tube dislocations and one case of peritonitis were found in 4/79 patients (5.1 %). One of these patients experienced two early major complications. Early minor complications, mainly local skin irritations and temporary stomach ache, were observed in 31 patients (39.2 %). Three days after CT-guided PG, 4 cases of major complications were documented, yielding a total rate of major complications was 8.7 % (7/79). Hemorrhage requiring blood transfusion or perforation after gastrostomy was not observed. 29.1 % of the patients (23/79) experienced late minor complications.

CONCLUSION

CT-guided percutaneous gastrostomy represents a relatively safe method with a high success rate for enabling gastrostomy in patients with high-grade obstructions of the upper digestive tract or inadequate transillumination. Standard complication classification provides an important basis for quality assessment and disclosure of risks. A classification of complications after gastrostomy is presented for this purpose.

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Publisher Full Text

Authors+Show Affiliations

Gottschalk A
Radiologie, Bundeswehrkrankenhaus Ulm, Ulm. andreas.gottschalk@gmx.net
Strotzer M
No affiliation info available
Feuerbach S
No affiliation info available
Rogler G
No affiliation info available
Seitz J
No affiliation info available
Völk M
No affiliation info available

MeSH

Deglutition DisordersEnteral NutritionFemaleGastrostomyHumansMaleMiddle AgedMonitoring, IntraoperativePostoperative ComplicationsStomach NeoplasmsTomography, X-Ray Computed

Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

17385134

Citation

Gottschalk, A, et al. "[CT-guided Percutaneous Gastrostomy: Success Rate, Early and Late Complications]." RoFo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin, vol. 179, no. 4, 2007, pp. 387-95.
Gottschalk A, Strotzer M, Feuerbach S, et al. [CT-guided percutaneous gastrostomy: success rate, early and late complications]. Rofo. 2007;179(4):387-95.
Gottschalk, A., Strotzer, M., Feuerbach, S., Rogler, G., Seitz, J., & Völk, M. (2007). [CT-guided percutaneous gastrostomy: success rate, early and late complications]. RoFo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin, 179(4), 387-95.
Gottschalk A, et al. [CT-guided Percutaneous Gastrostomy: Success Rate, Early and Late Complications]. Rofo. 2007;179(4):387-95. PubMed PMID: 17385134.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [CT-guided percutaneous gastrostomy: success rate, early and late complications]. AU - Gottschalk,A, AU - Strotzer,M, AU - Feuerbach,S, AU - Rogler,G, AU - Seitz,J, AU - Völk,M, PY - 2007/3/27/pubmed PY - 2007/11/6/medline PY - 2007/3/27/entrez SP - 387 EP - 95 JF - RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin JO - Rofo VL - 179 IS - 4 N2 - PURPOSE: Percutaneous endoscopic gastrostomy (PEG) and percutaneous radiologic gastrostomy (PRG) are the standard methods of ensuring long-term enteral food intake in patients with dysphagia caused by neoplasia or neurological disorders. High-grade obstructions of the upper digestive tract or inadequate transillumination can prevent PEG. CT-guided percutaneous gastrostomy (PG) represents a special technique for enabling gastrostomy in patients for whom the endoscopic method is impossible. The aim of this study was to evaluate the results and complications of CT-guided percutaneous gastrostomy. MATERIALS AND METHODS: CT-guided PG was performed in 83 patients, mostly with malignancy of the upper respiratory or digestive tract. Medical records for these patients were reviewed, and the results and complications of the CT-guided PG were analyzed retrospectively. Complications were grouped into four categories: Major and minor complications as well as early and late complications. RESULTS: In 95.2 % of all cases (79/83), CT-guided PG was successful in the first attempt. Within the first 3 days, 5 major complications including 4 tube dislocations and one case of peritonitis were found in 4/79 patients (5.1 %). One of these patients experienced two early major complications. Early minor complications, mainly local skin irritations and temporary stomach ache, were observed in 31 patients (39.2 %). Three days after CT-guided PG, 4 cases of major complications were documented, yielding a total rate of major complications was 8.7 % (7/79). Hemorrhage requiring blood transfusion or perforation after gastrostomy was not observed. 29.1 % of the patients (23/79) experienced late minor complications. CONCLUSION: CT-guided percutaneous gastrostomy represents a relatively safe method with a high success rate for enabling gastrostomy in patients with high-grade obstructions of the upper digestive tract or inadequate transillumination. Standard complication classification provides an important basis for quality assessment and disclosure of risks. A classification of complications after gastrostomy is presented for this purpose. SN - 1438-9029 UR - https://www.unboundmedicine.com/medline/citation/17385134/[CT_guided_percutaneous_gastrostomy:_success_rate_early_and_late_complications]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2007-962863 DB - PRIME DP - Unbound Medicine ER -