Cargando…

Percutaneous gastrostomy placement by intervention radiology: Techniques and outcome

BACKGROUND: Interventional radiology (IR) has played an important role in the technical evolution of gastrostomy, from the first surgical, endoscopical to percutaneous interventional procedures. AIM: This study is done to assess the technical feasibility and outcome of IR-guided percutaneous gastros...

Descripción completa

Detalles Bibliográficos
Autores principales: Karthikumar, Balasubramanian, Keshava, Shyamkumar N, Moses, Vinu, Chiramel, George K, Ahmed, Munawwar, Mammen, Suraj
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6038225/
https://www.ncbi.nlm.nih.gov/pubmed/30050247
http://dx.doi.org/10.4103/ijri.IJRI_393_17
_version_ 1783338454390669312
author Karthikumar, Balasubramanian
Keshava, Shyamkumar N
Moses, Vinu
Chiramel, George K
Ahmed, Munawwar
Mammen, Suraj
author_facet Karthikumar, Balasubramanian
Keshava, Shyamkumar N
Moses, Vinu
Chiramel, George K
Ahmed, Munawwar
Mammen, Suraj
author_sort Karthikumar, Balasubramanian
collection PubMed
description BACKGROUND: Interventional radiology (IR) has played an important role in the technical evolution of gastrostomy, from the first surgical, endoscopical to percutaneous interventional procedures. AIM: This study is done to assess the technical feasibility and outcome of IR-guided percutaneous gastrostomy for patients requiring nutritional support for neuromuscular disorders or head and neck malignancies, as well as to describe simplified and newer technique for pull-type gastrostomy. MATERIALS AND METHODS: This is a retrospective study including 29 patients who underwent IR-guided percutaneous gastrostomy over a period of 8 years in a tertiary-level institution. Either pull or push-type gastrostomy was performed in these patients as decided by the interventional radiologist. The procedures were assessed by analyzing the indications, technical aspects, and complications. STATISTICAL ANALYSIS: Descriptive summary statistics and frequencies were used to assess the techniques and related complications. RESULTS: The sample consists of 27 patients (93%) with pull technique and 2 patients (7%) with push technique. The technical success rate was 100%. Most of the complications were minor 24% (7/29), including superficial skin infections around the tube site, self-resolving pneumoperitoneum, tube-related complications such as block, leakage, deformation, and dislodgement. Three patients (10.3%) had major complications. One patient (3.4%) developed massive pneumoperitoneum and mild peritonitis due to technical failure in the first attempt and needed re-puncture for successful placement, and other two patients (6.9%) developed peristromal focal abscess. One patient died on the third postoperative day due to type II respiratory failure. CONCLUSION: IR-guided percutaneous gastrostomy is a safe and effective procedure in selected patients.
format Online
Article
Text
id pubmed-6038225
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-60382252018-07-26 Percutaneous gastrostomy placement by intervention radiology: Techniques and outcome Karthikumar, Balasubramanian Keshava, Shyamkumar N Moses, Vinu Chiramel, George K Ahmed, Munawwar Mammen, Suraj Indian J Radiol Imaging Interventional Radiology & Vascular BACKGROUND: Interventional radiology (IR) has played an important role in the technical evolution of gastrostomy, from the first surgical, endoscopical to percutaneous interventional procedures. AIM: This study is done to assess the technical feasibility and outcome of IR-guided percutaneous gastrostomy for patients requiring nutritional support for neuromuscular disorders or head and neck malignancies, as well as to describe simplified and newer technique for pull-type gastrostomy. MATERIALS AND METHODS: This is a retrospective study including 29 patients who underwent IR-guided percutaneous gastrostomy over a period of 8 years in a tertiary-level institution. Either pull or push-type gastrostomy was performed in these patients as decided by the interventional radiologist. The procedures were assessed by analyzing the indications, technical aspects, and complications. STATISTICAL ANALYSIS: Descriptive summary statistics and frequencies were used to assess the techniques and related complications. RESULTS: The sample consists of 27 patients (93%) with pull technique and 2 patients (7%) with push technique. The technical success rate was 100%. Most of the complications were minor 24% (7/29), including superficial skin infections around the tube site, self-resolving pneumoperitoneum, tube-related complications such as block, leakage, deformation, and dislodgement. Three patients (10.3%) had major complications. One patient (3.4%) developed massive pneumoperitoneum and mild peritonitis due to technical failure in the first attempt and needed re-puncture for successful placement, and other two patients (6.9%) developed peristromal focal abscess. One patient died on the third postoperative day due to type II respiratory failure. CONCLUSION: IR-guided percutaneous gastrostomy is a safe and effective procedure in selected patients. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6038225/ /pubmed/30050247 http://dx.doi.org/10.4103/ijri.IJRI_393_17 Text en Copyright: © 2018 Indian Journal of Radiology and Imaging http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Interventional Radiology & Vascular
Karthikumar, Balasubramanian
Keshava, Shyamkumar N
Moses, Vinu
Chiramel, George K
Ahmed, Munawwar
Mammen, Suraj
Percutaneous gastrostomy placement by intervention radiology: Techniques and outcome
title Percutaneous gastrostomy placement by intervention radiology: Techniques and outcome
title_full Percutaneous gastrostomy placement by intervention radiology: Techniques and outcome
title_fullStr Percutaneous gastrostomy placement by intervention radiology: Techniques and outcome
title_full_unstemmed Percutaneous gastrostomy placement by intervention radiology: Techniques and outcome
title_short Percutaneous gastrostomy placement by intervention radiology: Techniques and outcome
title_sort percutaneous gastrostomy placement by intervention radiology: techniques and outcome
topic Interventional Radiology & Vascular
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6038225/
https://www.ncbi.nlm.nih.gov/pubmed/30050247
http://dx.doi.org/10.4103/ijri.IJRI_393_17
work_keys_str_mv AT karthikumarbalasubramanian percutaneousgastrostomyplacementbyinterventionradiologytechniquesandoutcome
AT keshavashyamkumarn percutaneousgastrostomyplacementbyinterventionradiologytechniquesandoutcome
AT mosesvinu percutaneousgastrostomyplacementbyinterventionradiologytechniquesandoutcome
AT chiramelgeorgek percutaneousgastrostomyplacementbyinterventionradiologytechniquesandoutcome
AT ahmedmunawwar percutaneousgastrostomyplacementbyinterventionradiologytechniquesandoutcome
AT mammensuraj percutaneousgastrostomyplacementbyinterventionradiologytechniquesandoutcome