Polytetrafluoroethylene (Gore-Tex) tube used as a support conduit in open gastrostomy: report of a new technique.
Academic Article
Overview
abstract
BACKGROUND: When percutaneous endoscopic gastrostomy (PEG) or percutaneous radiographic gastrostomy (PRG) are not possible or fail, surgical gastrostomy would be the convenient method. Stamm's procedure has increasingly replaced other methods of surgical gastrostomy (SG). However, this procedure has various complications. In this study we used a Gore-Tex tube as a conduit to support a French 18 catheter for gastrostomy and evaluated its safety, efficacy, and usefulness in decreasing postoperative complications. METHODS: Forty patients with CNS trauma, swallowing dysfunction or esophageal obstruction and in whom PEG had either failed or was not possible were enrolled. Patients were randomized into two equal groups of Gore-Tex assisted modified Stamm's gastrostomy (GAMSG) and the conventional Stamm gastrostomy (CSG). In the GAMSG group we initially secured a 6-10 cm length and 8mm diameter tubular Gore-Tex to the gastric and abdominal wall as a conduit and then passed a French 18 catheter through it. Conventional Stamm procedure was applied to all patients in CSG group. Groups were compared for insertion times, pain, dislodgment, leakage rate, surrounding skin erythema and major complications. These patients were followed monthly for 6 months. RESULTS: The overall complication rate after GAMSG group was 5.3% (0% major) compared with 33.3% for Stamm gastrostomies (11.2% major) (p<0.05). Pain, operation site erythema, and tube leakage was significantly less in GAMSG group (p<0.05). CONCLUSIONS: Applying a tubular Gore-Tex conduit as a support for a feeding tube in Stamm's method effectively lowers complication rates without significantly increasing operation time or expenses.
