Comparison of balloon- and mushroom-retained large-bore gastrostomy catheters

OBJECTIVE. We conducted a retrospective study to evaluate two different typ es of percutaneous fluoroscopic gastrostomy procedures and catheters. MATERIALS AND METHODS. Between July 8, 1999, and August 4, 2000, 80 percuta neous gastrostomy catheters were placed in 80 patients in 80 attempts. Twen ty-five 16-, 18-, or 20-French balloon-retained catheters and 55 20-French mushroom-retained catheters were inserted. Typically, the type of catheters placed was based on operator preference. However, balloon-retained tubes w ere preferred for use in patients with obstructive head and neck or esophag eal malignancies, and mushroom-retained catheters were preferred for use in demented or combative patients. Follow-up was conducted through chart revi ews and telephone interviews. The technical success, procedural complicatio ns, and catheter complications were recorded. Chi-square statistical analys is was performed. RESULTS. Technical success was 100% (80/80 patients), and no procedural com plications occured. In patients who received balloon-retained catheters, th e major complication rate was 0%, the minor complication rate was 8% (2/25 patients), and the tube complication rate was 68% (17/25 patients). The fol lowing complications occurred: catheter dislodgment (n = 17), superficial c ellulitis (n = 1), and bleeding gastric ulcer (n = 1). In patients who rece ived mushroom-retained catheters, the major complication rate was 0%, the m inor complication rare was 3.6% (2/55 patients), and the tube complication rate was 3.6% (2/55 patients). The following complications occurred: superf icial cellulitis (n = 2), tube occlusion (n = 1), and peristomal tube leaka ge (n = 1), No significant differences in major or minor complications were found between the gastrostomy procedures. Balloon-retained catheters had a significantly higher rate: of tube complications (p < 0.001). CONCLUSION. Compared with balloon-retained catheters, mushroom-retained gas trostomy catheters are significantly more durable, more secure, and less pr one to tube dysfunction, Mushroom-retained catheters should be the preferre d type of gastrostomy catheter to place in patients whenever possible.