Tube gastrostomy. Techniques and complications.

Area of Science:

• Gastroenterology
• Surgical Procedures
• Patient Safety

Background:

• Nasogastric tubes are often used for prolonged gastrointestinal decompression or enteral nutrition.
• Gastrostomies are considered a preferable alternative for these indications.

Purpose of the Study:

• To assess the safety and complication rates of tube gastrostomy procedures.
• To compare feeding gastrostomies with decompression gastrostomies.
• To identify factors influencing gastrostomy complications.

Main Methods:

• Systematic review of 424 gastrostomies from a total of 3,359 procedures performed between 1975 and 1980.
• Analysis of complication types (major/minor), patient age, perioperative steroid use, gastrostomy method, catheter type, and suturing techniques.

Main Results:

• Overall complication rates were low: 6.6% major and 6.6% minor.
• Complications were not influenced by patient age or perioperative steroid therapy.
• Feeding gastrostomies showed a higher incidence of internal leakage compared to decompression gastrostomies.
• Suturing the gastrostomy site to the anterior abdominal wall reduced the risk of peritoneal extravasation after tube removal.

Conclusions:

• Tube gastrostomies are a safe and effective alternative to prolonged nasogastric intubation.
• The Stamm technique with a straight catheter and anterior gastropexy minimizes potential problems.
• Careful technique and patient selection can further reduce complication risks.