COMPARISON OF FOLEY CATHETER AS A REPLACEMENT GASTROSTOMY TUBE WITH COMMERCIAL REPLACEMENT GASTROSTOMY TUBE - A PROSPECTIVE RANDOMIZED TRIAL

Percutaneous endoscopic gastrostomy (PEG) provides a non-surgical alte rnative to long-term enteral feeding. The gastrostomy tube, however, m ay deteriorate, malfunction, or be accidentally expelled, requiring re placement. A commercial gastrostomy tube is commonly used for replacem ent. However, a commercial replacement gastrostomy tube is many times more expensive than a Foley catheter, and the two have never been comp ared. We compared the efficacy and safety of an all-silicone Foley cat heter used as a replacement feeding gastrostomy tube with the effectiv eness of a commercial replacement gastrostomy tube in 46 patients unde rgoing long-term enteral feedings per gastrostomy. Twenty-four patient s were randomized to the Foley group and 22 patients to the commercial replacement gastrostomy tube group, The Foley catheter functioned wel l without need for replacement in 16 (66%) patients for 27.4 +/- 14.8 (mean +/- SD) weeks; the commercial replacement gastrostomy tube funct ioned in 13 (59%) patients for 24.5 +/- 13.6 weeks (p > 0.05, NS). The Foley catheter needed to be replaced because of malfunction in 8 (34% ) patients and the commercial replacement gastrostomy tube in 9 (41%) patients after 21.6 +/- 11.5 weeks and 19.3 +/- 9.3 weeks, respectivel y (p > 0.05, NS). Neither the Foley catheter nor the commercial replac ement gastrostomy tube migrated; this was the most striking finding, i n contrast to case reports in the literature. Our data suggest that th e Foley catheter can be safely used as a replacement gastrostomy tube; it is considerably cheaper than the commercial replacement gastrostom y tube, and its efficacy and complication rates are similar to those o f the commercial replacement gastrostomy tube.