Gastrostomy Tube Placement by Radiological Methods for Older Patients Requiring Enteral Nutrition: Not to be Forgotten

Gastrostomy Tube Placement by Radiological Methods for Older Patients Requiring Enteral Nutrition: Not to be Forgotten

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Background: The use of gastrostomy tubes for long-term nutritional support in older patients is frequent.Percutaneous gastrostomy tube placement may be performed using various techniques, including endoscopic, surgical, and radiologically-guided methods.While percutaneous endoscopic gastrostomy (PEG) placement is the most widely used Gut Rescue and accepted approach, experience with the use of percutaneous radiological gastrostomy (PRG) is more limited.

Objective: To evaluate the safety and short-term outcomes of PRG in older patients requiring long-term enteral feeding.Method: We performed a prospective study involving all patients aged 65 years and older who underwent PRG insertion at the Laniado hospital over a period of 2 years.Adverse events related to the gastrostomy tube insertion were recorded over a period of 3 months following the procedure.

Results: A total of 58 patients were included with a mean age of 78.1 years, and 48% were women.The most frequent indications for enteral feeding were stroke (47%) and dementia (41%).

The technical success rate was 100% with no immediate procedure-related mortality or morbidity.One-month mortality was 3%, and overall mortality at 3-month follow-up was 16%.Complications were reported in Funko Exclusive 39 (67%) of patients, with 17 (29%) experiencing more than 1 complication.

While most complications (88%) were minor, major complications occurred in 19 (33%) of the patients.Peritonitis was the cause of death in 2 patients, and tube dislodgment occurred in 17 subjects.During the follow-up period 17 (29%) of patients were re-admitted to hospital, with the cause for re-hospitalization being unrelated to the PRG in half of the cases.

Neither bleeding nor deep wound infection was detected in the study group.Conclusions: PRG is relatively safe and effective for gastrostomy placement in older patients, and this technique may be of value in patients with oral infections and those receiving anti-thrombotic therapy.