T-Fastener Migration after Percutaneous Gastropexy for Transgastric Enteral Tube Insertion
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Background/Aims: To determine the prevalence and timecourseof t-fastener migration after gastropexy deployment. Methods: We reviewed our procedural database for all percutaneousgastrostomy and gastrojejunostomy tube insertionsperformed over a 14-month period using a widely acceptedt-fastener kit for gastropexy (Kimberly-Clark). Of 201 patients,71 (41 males, 30 females; mean age, 56 years) underwentsubsequent abdominal computed tomography (CT) imaging. The location and associated findings of each t-fastener wereretrospectively recorded for each CT scan performed afterthe tube insertion. Results: A total of 153 t-fasteners weredeployed during 71 procedures with subsequent CT followup. In the short term (within 4 weeks after deployment), 5.1%of the t-fasteners had detached and were no longer present;59.5% were intraluminal or within the gastric wall; and35.5% were within the anterior abdominal wall musculatureor subcutaneous. In the long term (>3 months), 48.6% of thet-fasteners had detached and were no longer present, 25.0%were intraluminal or within the gastric wall, and 26.4% werewithin the anterior abdominal wall musculature or subcutaneous. No t-fastener-related complications, such as abscesses,fluid collections, or fistulae, were identified. Conclusions: Following gastropexy for percutaneous transgastric feedingtube placement, t-fastener migration into the abdominal wallfrequently occurred soon after the tube insertion. Therefore,recent t-fastener deployment does not guarantee an intact gastropexy.
Abstract
Background/Aims: To determine the prevalence and timecourseof t-fastener migration after gastropexy deployment. Methods: We reviewed our procedural database for all percutaneousgastrostomy and gastrojejunostomy tube insertionsperformed over a 14-month period using a widely acceptedt-fastener kit for gastropexy (Kimberly-Clark). Of 201 patients,71 (41 males, 30 females; mean age, 56 years) underwentsubsequent abdominal computed tomography (CT) imaging. The location and associated findings of each t-fastener wereretrospectively recorded for each CT scan performed afterthe tube insertion. Results: A total of 153 t-fasteners weredeployed during 71 procedures with subsequent CT followup. In the short term (within 4 weeks after deployment), 5.1%of the t-fasteners had detached and were no longer present;59.5% were intraluminal or within the gastric wall; and35.5% were within the anterior abdominal wall musculatureor subcutaneous. In the long term (>3 months), 48.6% of thet-fasteners had detached and were no longer present, 25.0%were intraluminal or within the gastric wall, and 26.4% werewithin the anterior abdominal wall musculature or subcutaneous. No t-fastener-related complications, such as abscesses,fluid collections, or fistulae, were identified. Conclusions: Following gastropexy for percutaneous transgastric feedingtube placement, t-fastener migration into the abdominal wallfrequently occurred soon after the tube insertion. Therefore,recent t-fastener deployment does not guarantee an intact gastropexy.
참고문헌 (11)
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