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Objectives: We aimed to describe and compare the complications associated with different percutaneous radiologic gastrostomy (PRG) techniques., Methods: A retrospective and prospective observational study was conducted. Patients who underwent a PRG between 1995-2020 were included., Techniques: A pigtail catheter was used until 2003, a balloon catheter without pexy was used between 2003-2009 and a balloon catheter with gastropexy was used between 2015-2021. For the comparison of proportions, X 2 tests or Fisher's test were used when necessary. Univariate analysis was performed to study the risk factors for PRG-associated complications., Results: n = 330 (pigtail = 114, balloon-type without pexy = 28, balloon-type with pexy = 188). The most frequent indication was head and neck cancer. The number of patients with complications was 44 (38.5%), 11 (39.2%) and 54 (28,7%), respectively. There were seven (25%) cases of peritonitis in the balloon-type without-pexy group and 1 (0.5%) in the balloon-type with-pexy group, the latter being the only patient who died in the total number of patients (0.3%). Two (1%) patients of the balloon-type with-pexy group presented with gastrocolic fistula. The rest of the complications were minor., Conclusions: The most frequent complications associated with the administration of enteral nutrition through PRG were minor and the implementation of the balloon-type technique with pexy has led to a decrease in them.

Introduction: Gastrostomy feeding tube insertion has become a common procedure as it enables patients who require long term enteral feeding. Conventional surgical gastrostomies were the only way of gaining enteral access in patients in which it is not possible to pass an endoscope or a nasogastric tube required for endoscopic or radiological gastrostomies, and in patients in which certain anatomical abnormalities contraindicate performing these techniques. As conventional surgical gastrostomies are associated with high morbidity, especially gastric leakage around the tube, percutaneous laparoscopic assisted gastrostomy (PLAG) may be a better way to gain enteral access., Material and Methods: Observational study of a prospective cohort of 224 patients on whom a gastrostomy was performed for nutritional support between January 2009 and October 2015 at Virgen del Rocío University Hospital in Seville. The types of gastrostomies carried out were: percutaneous endoscopic gastrostomy (PEG, n = 106), percutaneous radiological gastrostomy (PRG, n = 89), conventional surgical gastrostomy, Open Stamn or Laparoscopic Janeway (SG, n = 9) and percutaneous laparoscopic assisted gastrostomy (PLAG, n = 20), technique that we describe in detail. Short and long term complications are described., Results: Many more complications were seen in the conventional gastrostomy group than in the other three groups, especially leakage of gastric content around the tube, with burning and irritation of the skin (66% compared with 2.83% in PEG and 0% in PLAG and PRG). The group with the highest proportion of patients completely free of complications was PLAG (75%), whilst in the conventional surgical gastrostomy group, no patient was completely free of complications., Conclusions: We found lower complication rate in PLAG than any other technique. We believe that PLAG could be preferred technique for patients on whom it is not possible to perform PEG or PRG, as it is safe and easy., (Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

When assessing a patient nutritional support the state of the gastrointestinal tract is the most important point to consider, whenever possible we should choose the enteral nutrition (EN) over parenteral nutrition (PN) and recognized by its various advantages. The percutaneous gastrostomy (GRP) were introduced in clinical practice as an alternative to surgical gastrostomy (GQ). The speed, simplicity, low cost, low morbidity and low mortality of these techniques has allowed its rapid development.The feeding tubes types used were the balloon-retained devices catheter, the pig tail and the ballon-retained with gastropexia (gastropexia). It is a retrospective study of all patients who were placed GPR in the Virgen del Rocío University Hospital, Sevilla, between September 1996 and September 2013, which aims to study is to describe the characteristics of patients and the complications presented for different types of enteral feeding tubes used. GPR 186 were performed in 176 patients (135 males (76.70%), with an average duration of 303.6 days, the most frequent diseases were cancers of the head and neck 49.46%. The types of feeding tubes used were pigtail 118 (63.44%), balloon-retained devices 22 (11.83%), and gastropexia 46 (24.73%). The most common early complications in the pigtail group were early purulent exudate and early bleeding (2.5 and 3.4% respectively), while in the balloon catheter group the initial output of the probe was most frequent early complication (13.7%), none of these complications were observed in the group of gastropexy. The most common late complication was obstruction probe. The GPR is a safe technique with lower mortality of 1%; Low frequently of early and late complications. A better understanding of this technique can reduce the frequency of complications., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Introduction: Percutaneous gastrostomy, is the procedure of choice to provide enteral access in patients requiring nutritional support in this way in the long run, relegating the surgical gastrostomy., Material and Methods: We present three patients requiring percutaneous gastrostomy for nutritional support. In two cases was performed endoscopic gastrostomy and another one using interventional radiology., Results: While performing percutaneous gastrostomy clinical incidents were not detected, but when trying the replacement of gastrostomy tubes, showed the presence of gastrocolic fistula that caused failure or turnover in one case, or abdominal pain and diarrhea in the two other cases., Discussion: Despite being a safe technique, should be done a proper patient selection in order to minimize the potential complications that may occur, as gastrocolic fistula, recommending in doubtful cases test of image such CT (computerized Tomography)., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Aim: Exposing the complications of surgical gastrostomies used as way of home enteral nutritional support (HEN) and detecting the differences between the two techniques used in our environment: Open Surgery vs Laparoscopic Surgery., Material and Methods: Retrospective descriptive observational study of the surgical gastrostomies performed between 1994 and 2009 followed up by our unit. Have been analyzed the complications detected in our practice during the follow-up of patients with HEN performed via open laparotomy vs. laparoscopic tecniques, assessing: leaks of gastric fluid to the exterior, abdominal wall irritation, presence of exudate, presence of exudate with positive culture that required antibiotical treatment, burning or loss of substance of the periostomic zone, breach of balloon, decubitus ulcer caused by the tube and formation of granuloma., Results: Between 1994 and 2009, 57 surgical gastrostomies were performed: 47 using the conventional laparotomic (open) tecnique and 10 laparoscopies. The average age of the patients was 57.51 ± 17.29 years old. The most common cause for the performance of surgical gastrostomy was esophageal cancer (38.6%) followed by neurologic alterations (26.3%) and head and neck tumors (26.3%). 97.9% of the patients who underwent to surgical gastrostomy presented at least one complication, meaning that only 2.1% were free of complications; meanwhile, 50% of the patients were laparoscopic gastrostomy was performed had none of these complications. The most common complications were the presence of leaks of gastric fluid and abdominal wall irritation that appeared on 89.4% and 83% respectively of the laparotomic gastrostomies versus the presence of only 30% of both complications in laparoscopic gastrostomies being the difference statistically significant (p < 0.01)., Conclusions: After the introduction of the laparoscopic technique in the performance of surgical gastrostomies has been observed a decrease of the complications occured during the home enteral nutritional support related to surgical gastrostomies.

Background: This study aimed to review our experience during 8 years in the use of percutaneous endoscopic gastrostomy (PEG) and its application in home enteral nutrition (HEN)., Material: We studied 207 patients (56 women and 151 men) who had undergone a PEG from the beginning of 1994 to the end of 2002 as they needed prolonged enteral nutrition (> 4 weeks). In those cases in which home enteral nutrition was programmed, the patients/relatives were trained in the techniques and care of the PEG and EN, and the control was done through the nutrition out-patient clinic., Results: Mean duration time of the PEG was 640 days and 175 patients (84.6%) needed PEG for more than 60 days and 135 for more than 6 months. Mean calorie supply was 1,730 +/- 288 Kcal/day. Administration mode was by intermittent infusion due to seriousness in 162 cases and continuous infusion through volemetric pump in 45 patients. In 2 patients with hyperemesis gravidarum, percutaneous endoscopic gastrojejunostomy (PEGJ) was done in the 3rd and 4th month of pregnancy, the pregnancy finishing successfully by vaginal delivery. Performance of PEG facilitated hospital discharge and programming of home enteral nutrition in 195 patients (94%). The most frequent complications were gastrostomy infection that occurred in 41 patients and the appearance of granuloma in the ostomy in 34 cases. Only one patient died in direct relationship due to peritonitis after PEG., Conclusion: Our study includes the advantages of PEG as an enteral nutrition technique, permitting the establishment of a home enteral nutrition program with limited incidence of complications and very low mortality.