Long-term alimentation by a new indwelling tube gastrostomy technique

Use of a Gore-Tex peritoneal catheter as a feeding gastrostomy tube can virtually eliminate the complications associated with long-term feeding gastrostomy. The tube consists of a radiopaque 18 F silicone rubber catheter having a toadstool-shaped, expanded polytetrafluorethylene flange and cuff around its midportion. Epithelial tissue grows into the interstices of the Gore-Tex flange, and fibroplasia incorporates the cuff into the tissue, fixing the tube firmly in place and preventing its inadvertent removal. In addition, the tissue ingrowth creates a physiologic barrier that prevents efflux of intragastric contents and discourages influx of microorganisms or other contaminants along the gastrostomy tract. Thus far, Gore-Tex feeding gastrostomies have been placed for two to 11 months in six critically ill malnourished patients who required long-term or permanent gastrostomy feeding. No complications have occurred, patient safety and satisfaction have been greatly increased, efficacy of nutritional rehabilitation has been enhanced, and the patients' quality of life has been vastly improved.