Percutaneous radiologic gastrostomy catheter placement without gastropexy: a co-axial balloon technique and evaluation of safety and efficacy

Purpose

The purpose of this study is to evaluate the short-term safety and efficacy of a co-axial angioplasty balloon technique for percutaneous radiologic gastrostomy catheter placement (PRG).

Methods

A total of 65 percutaneous radiologic gastrostomy tube placements were performed with the co-axial angioplasty balloon technique from 10/1999 to 1/2014. This included 19 females and 46 males between the ages of 20–83. Without the use of T-fasteners for gastropexy, the gastrostomy tube was placed over a catheter-shaft angioplasty balloon as a co-axial system. The angioplasty balloon was used to sequentially approximate the stomach wall to the abdominal wall, dilate the tract, and was then used as a dilator to aid gastrostomy tube advancement into the gastric lumen. Technical success, complications, and dislodgements were evaluated by means of retrospective review of patient medical records and imaging.

Results

There was no procedural failure in any of the 65 placements. 30-day follow-up was available for 56 patients. 7 patients died within 30 days; none of the deaths were recorded as procedure-related. There was 1 major complication (1.5%) consisting of a colocutaneous fistula. There were 4 minor complications (6.2%). There was no occurrence of bleeding or skin infection while using this technique.

Conclusions

PRG with the co-axial angioplasty-balloon technique is a safe and effective technique for gastrostomy placement.

     

A guide to managing the pain of treatment-related oral mucositis

Oral mucositis is a common complication of chemotherapy and/or radiotherapy and can be a significant problem for patients undergoing cancer treatment or bone marrow transplantation. Frequently, there is a major adverse impact on quality of life, particularly with pain and interference with oral function. In patients who are immunocompromised or debilitated, this complication can become life threatening. Currently, there is no single intervention that completely prevents or treats oral mucositis. The object of this article is to provide an overview for the nurse of the evidence for several options that may be of value in managing the pain which is often associated with this condition.