Radiologic, endoscopic, and surgical gastrostomy: an institutional evaluation and meta-analysis of the literature

Radiology. 1995 Dec;197(3):699-704. doi: 10.1148/radiology.197.3.7480742.

Abstract

Purpose: To evaluate the effectiveness and safety of radiologic, percutaneous endoscopic (PEG), and surgical gastrostomy.

Materials and methods: This project involved 5,752 patients (837 patients underwent radiologic gastrotomy; 4,194, PEG; and 721, surgical gastrostomy). Seventy-two (47 male, 25 female; age range, 12-94 years) underwent gastrostomy within 1 year in this series (radiologic gastrostomy, n = 33; PEG, n = 35; surgical gastrostomy, n = 4). A meta-analysis of 5,680 additional cases from literature published from 1980 to the present was also performed.

Results: Rates of successful tube placement were higher for radiologic gastrostomy than for PEG in our series and in the meta-analysis (99.2% vs 95.7%, P < .001). Major complications occurred less frequently after radiologic gastrostomy in our series and in the meta-analysis (5.9% vs 9.4% for PEG and 19.9% for surgery, P < .001). Thirty-day procedure-related mortality rates were highest for surgery (2.5% vs 0.3% for radiologic gastrostomy and 0.53% for PEG, P < .001).

Conclusion: Radiologic gastrostomy is associated with a higher success rate than is PEG and less morbidity than either PEG or surgery.

Publication types

  • Meta-Analysis

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, Local
  • Child
  • Conscious Sedation
  • Costs and Cost Analysis
  • Enteral Nutrition / adverse effects
  • Enteral Nutrition / economics
  • Enteral Nutrition / instrumentation
  • Enteral Nutrition / methods*
  • Evaluation Studies as Topic
  • Female
  • Follow-Up Studies
  • Gastroscopy* / adverse effects
  • Gastroscopy* / economics
  • Gastroscopy* / methods
  • Gastrostomy / adverse effects
  • Gastrostomy / economics
  • Gastrostomy / instrumentation
  • Gastrostomy / methods*
  • Humans
  • Male
  • Middle Aged
  • Pain, Postoperative / prevention & control
  • Radiology, Interventional* / economics
  • Radiology, Interventional* / methods
  • Risk Assessment
  • Safety
  • Survival Rate
  • Time Factors