Purpose

To examine the safety and efficiency of balloon-assisted gastrostomy for insertion of large bore feeding tubes compared to conventional techniques using dilators.

Materials and Methods

Retrospective review of all fluoroscopically guided percutaneous gastrostomy tube insertions between July 2017 and September 2019 was performed. Collected data points included patient demographics, initial pathology, type of gastrostomy tube (G tube) inserted [(Avanos standard balloon retained (Mic-G), or low-profile balloon retained (Mic-Key)], type of insertion technique (balloon-assisted or -nested dilator technique), fluoroscopy time, amount of sedation required, technical success, and complications. The focus of the study was method of tract dilatation – either balloon-assisted gastrostomy (BAG group) versus nested or sequential dilators (dilator group). Two hundred patients were included in this study; 100 patients were evaluated in each group.

Results

There were no significant differences between the two groups. The overall rate of minor complications (grades 1 and 2, according to the CIRSE classification system) was higher in the dilator group (11%, compared to 7% in the BAG group) but did not reach statistical significance. Males were associated with lower risk of minor complications (OR 0.19, 95% CI (0.07, 0.53)), while age did not present a significant association. Patients in the BAG group received a significantly lower amount of fentanyl (p < 0.001) and midazolam (p < 0.001) than patients in the dilator group.

Conclusion

Balloon-assisted gastrostomy is a safe and effective technique for large bore gastrostomy placement. Patients required less sedation, allowing for faster recovery and discharge time in outpatients at our institution.

中文翻译：

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球囊辅助胃造口术的效率和安全性

目的

与使用扩张器的传统技术相比，检查球囊辅助胃造口术插入大口径饲管的安全性和效率。

材料和方法

对 2017 年 7 月至 2019 年 9 月期间所有经透视引导的经皮胃造瘘管插入进行了回顾性审查。收集的数据点包括患者人口统计学、初始病理、插入的胃造口管（G管）类型[（Avanos 标准球囊保留 (Mic-G) 或低轮廓球囊保留 (Mic-Key)]、插入技术类型（球囊辅助或嵌套扩张器技术）、透视时间、所需镇静量、技术成功和并发症。研究的重点是扩张管道的方法——球囊辅助胃造口术（BAG 组）与嵌套或顺序扩张器（扩张器）本研究共纳入 200 名患者，每组评估 100 名患者。

结果

两组之间没有显着差异。扩张器组的轻微并发症（根据 CIRSE 分类系统为 1 级和 2 级）的总体发生率较高（11%，而 BAG 组为 7%），但未达到统计学意义。男性发生轻微并发症的风险较低（OR 0.19，95% CI (0.07, 0.53)），而年龄没有显着相关性。BAG 组患者接受的芬太尼 ( p  < 0.001) 和咪达唑仑 ( p  < 0.001)量显着低于扩张器组患者。

结论

球囊辅助胃造口术是一种安全有效的大口径胃造口术放置技术。患者需要较少的镇静剂，从而使我们机构的门诊患者能够更快地恢复和出院。