Witzel gastrostomy in gynecologic surgery

Tube gastrostomy is a well-accepted procedure for gastrointestinal decompression and the relief of small bowel obstruction. The Witzel technique was used in 123 patients undergoing pelvic-abdominal surgery for known or suspected gynecologic malignancy or for clinical bowel obstruction. For 115 patients, the tube remained in place from 3 to 18 days (mean, 8 days). Eight patients were discharged from the hospital with the tube in place, and these functioned successfully from 43 to 136 days. Sixteen patients (13%) had complications, but there was neither long-term morbidity nor mortality associated with the tube. Witzel gastrostomy, using a Foley catheter, is easily learned, inexpensive, and has an acceptable complication rate. When the need for long-term gastrointestinal decompression is anticipated, Witzel gastrostomy is preferred to nasogastric tube suctioning to facilitate patient care and comfort.