Randomized Controlled Trial of Percutaneous Radiologic Gastrostomy Performed With and Without Gastropexy: Technical...

Area of Science:

• Gastroenterology
• Interventional Radiology
• Surgical Innovation

Background:

• Percutaneous radiologic gastrostomy (PRG) is a common procedure for enteral feeding access.
• Gastropexy, a technique to secure the gastric tube, is sometimes employed during PRG insertion.
• The impact of gastropexy on patient outcomes, particularly pain and complications, requires further elucidation.

Purpose of the Study:

• To compare patient-reported pain and outcomes following balloon-retention PRG insertion with and without gastropexy.
• To assess technical outcomes, quality of life, and complication rates between the two PRG insertion methods.

Main Methods:

• A single-centre, randomized trial involving 60 patients undergoing primary 14-French PRG tube insertion.
• Patients were randomized to either PRG with gastropexy or PRG without gastropexy.
• Data collected included procedural time, pain scores, quality of life (EQ5D-5L, VAS, FACT-EN), and complications up to 6 months.

Main Results:

• Procedural time was significantly longer for PRG with gastropexy (11.4 min) compared to without (6.79 min; p < 0.05).
• No significant differences in pain scores or 1-month quality of life parameters were observed between groups.
• Minor complication rates were similar (20% gastropexy vs. 31% non-gastropexy), with two major complications in the non-gastropexy group.

Conclusions:

• Balloon-retention PRG insertion with or without gastropexy demonstrates comparable patient tolerability regarding pain and quality of life.
• A trend towards fewer complications was observed with the utilization of gastropexy.
• Larger randomized trials are warranted to definitively compare complication rates between PRG insertion with and without gastropexy.