AUTHOR=Piñar-Gutiérrez Ana , Serrano-Aguayo Pilar , Gutiérrez Rocío Vázquez , Rey Silvia García , González-Navarro Irene , Tatay-Domínguez Dolores , Garrancho-Domínguez Pilar , Remón-Ruiz Pablo J. , Martínez-Ortega Antonio J. , Mejías Verónica Nacarino , Iglesias-López Álvaro , Socas María , Morales-Conde Salvador , García-Fernández Francisco José , Bozada-García Juan Manuel , Pereira-Cunill José Luis , García-Luna Pedro Pablo 

TITLE=Gastrostomies: experience and complications with three modalities in a tertiary centre over a 26-year period

JOURNAL=Frontiers in Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1191204

DOI=10.3389/fmed.2023.1191204

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Objectives</title><p>To describe the complications associated with the different gastrostomy techniques [endoscopic (PEG), radiologic (PRG), and surgical (SG)] performed in the last 26 years in a terciary hospital.</p></sec><sec id="sec2"><title>Methods</title><p>Retrospective observational study. Patients who underwent gastrostomy at the Virgen del Rocío University Hospital between 1995 and 2021 were included. For PEG, the PULL technique was performed until 2018 and subsequently the PUSH technique predominantly. For PRG, a pigtail catheter was used until 2003, a balloon catheter between 2003 and 2009, and a balloon catheter with gastropexy between 2015 and 2021. For SG, the conventional technique (CSG) was performed until 2009 and since then the laparoscopic assisted percutaneous gastrostomy (PLAG) technique. Descriptive analysis was performed obtaining the median and quartiles of the quantitative variables [P50 (P25-P75)] and the frequency for the qualitative variables [<italic>n</italic> (%)].The comparison of complications between patients who underwent different techniques was performed with Fisher’s test.</p></sec><sec id="sec3"><title>Results</title><p><italic>n</italic> = 1,070 (PEG = 608, PRG = 344, SG = 118). The three most frequent indications were head and neck tumors, neurological diseases and gastroesophageal tumors. The percentage of patients who had any complication was 48.9% (PEG-PULL), 23.7% (PEG-PUSH), 38.5% (pigtail PRG), 39.2% (balloon PRG), 29.7% (balloon with gastropexy PRG), 87.3% (CSG), and 41.26% (PLAG). 2 (0.18%) patients died from gastrostomy-related complications. 18(1.68%) presented with peritonitis and 5 (0.4%) presented with gastrocolic fistula. The rest of the complications were minor.</p></sec><sec id="sec4"><title>Conclusion</title><p>Gastrostomy in any of its modalities is currently a safe procedure with a low rate of complications, most of which are minor.</p></sec>