OUTCOMES OF SURGICAL, PERCUTANEOUS ENDOSCOPIC, AND PERCUTANEOUS RADIOLOGIC GASTROSTOMIES

Objectives: To evaluate and compare outcomes and complications in pati ents having undergone gastrostomy by surgical (SG), percutaneous endos copic (PEG), or percutaneous radiological (PRG) procedure. Design: Ret rospective analysis. Setting: University-based tertiary care center. P atients: Of 82 patients who met inclusion criteria, 14 patients (media n age, 40 years) received a surgical tube placement (SG), in 24 patien ts (median age, 55 years)a PEG procedure was performed, and in 44 pati ents (median age, 57 years) the tube was placed under fluoroscopic gui dance (PRG). Indications for gastrostomy were similar in all groups, r epresenting mainly cancer of the oropharyngeal, head and neck region ( 51 [61%]) as well as the upper gastrointestinal tract (6 [8%]), neurol ogical disorders (15 [18%]), and others (10 [13%]). Main Outcome Measu res: Catheter function rates, major and minor procedure-related compli cations, and survival. Results: Median follow-up was 17.2 months. Ten patients (71%) died in the SG group 7 to 855 days (median, 67 days) af ter the procedure, 7 patients (29%) died 5 to 263 days (median, 103 da ys) after PEG placement, and 30 patients (68%) died within 3 to 621 da ys (median, 112 days) after PRG, of their underlying disease or diseas e-related complications; 1 procedure-related death occurred 6 days aft er radiological tube placement. We observed a rate of minor complicati ons of 43% (6 patients), 33% (8), and 36% (16) and a major complicatio n rate of 14% (2 patients), 17% (4), and 11% (5) in the SG, PEG, and P RG groups, respectively. Tube function rates at 1 year were 67% (9 pat ients) and 68% (20) in the SG and PEG groups, respectively, and 10% lo wer (39) in the PRG group, although the difference was not statistical ly significant. Conclusions: There is no major difference between SG, PEG, and PRG concerning procedure-related complications. Tube function tends to be inferior after radiological tube placement.