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.