Author:
Chang-ming Hu,Xiao-mei Qi,Li Liu,Qing-Hua Liang,Jun-ru Xiong,Liang-shan Li,Liang-yu Deng,Xue-quan Huang,Chuang He
Abstract
Abstract
Purpose
To compare the safety and efficacy of CPG in the rectus abdominis and intercostal regions.
Materials and methods
This retrospective study included 226 patients who underwent CPG at a single center, with the stoma placed in the rectus abdominis or intercostal region. Surgical outcomes and complications, such as pain and infection within 6 months postoperatively, were recorded.
Results
The surgical success rate was 100%, and the all-cause mortality rate within 1 month was 0%. An intercostal stoma was placed in 56 patients; a rectus abdominis stoma was placed in 170 patients. The duration of surgery was longer for intercostal stoma placement (37.66 ± 14.63 min) than for rectus abdominis stoma placement (30.26 ± 12.40 min) (P = 0.000). At 1 month postsurgery, the rate of stoma infection was greater in the intercostal group (32.1%) than in the rectus abdominis group (20.6%), but the difference was not significant (P = 0.077). No significant difference was observed in the infection rate between the two groups at 3 or 6 months postsurgery (P > 0.05). Intercostal stoma patients reported higher pain scores during the perioperative period and at 1 month postsurgery (P = 0.000), but pain scores were similar between the two groups at 3 and 6 months postsurgery. The perioperative complication rates for intercostal and rectus abdominis surgery were 1.8% and 5.3%, respectively (P = 0.464), with no significant difference in the incidence of tube dislodgement (P = 0.514). Patient weight improved significantly at 3 and 6 months postoperatively compared to preoperatively (P < 0.05).
Conclusion
Rectus abdominis and intercostal stomas have similar safety and efficacy. However, intercostal stomas may result in greater short-term patient discomfort.
Publisher
Springer Science and Business Media LLC
Reference25 articles.
1. Laasch HU, Martin DF. Radiologic gastrostomy. Endoscopy. 2007;39:247–55.
2. Thornton FJ, Varghese JC, Haslam PJ, McGrath FP, Keeling F, Lee MJ. Percutaneous gastrostomy in patients who fail or are unsuitable for endoscopic gastrostomy. Cardiovasc Intervent Radiol. 2000;23:279–84.
3. Wang T, Wen Q, Zhang Y, Yuan J, Gao C, Hu H, Chen C, Zheng L, Li F, Li Y, Lu J, Li H. Percutaneous gastrostomy compared with esophageal stent placement for the treatment of esophageal cancer with dysphagia. J Vasc Interv Radiol. 2021;32:1215–20.
4. Ahmed Z, Iqbal U, Aziz M, Arif SF, Badal J, Farooq U, Lee-Smith W, Gangwani MK, Kamal F, Kobeissy A, Mahmood A, Nawras A, Khara HS, Confer BD, Adler DG. Outcomes and complications of radiological gastrostomy vs. percutaneous endoscopic gastrostomy for enteral feeding: an updated systematic review and meta-analysis. Gastroenterology Res. 2023;16:79–91.
5. Kohli DR, Radadiya DK, Patel H, Sharma P, Desai M. Comparative outcomes of endoscopic and radiological gastrostomy tube placement: a systematic review and meta-analysis with GRADE analysis. Ann Gastroenterol. 2022;35:592–602.