Han Kichang, Kim Man-Deuk, Kwon Joon Ho, Kim Yong Seek, Kim Gyoung Min, Lee Junhyung, Choi Woosun, Won Jong Yun, Lee Do Yun
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul 120-752, Korea.
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul 120-752, Korea.
J Vasc Interv Radiol. 2017 Dec;28(12):1702-1707. doi: 10.1016/j.jvir.2017.06.031. Epub 2017 Aug 10.
To prospectively compare 2 different types of percutaneous fluoroscopic gastrostomy procedures (pigtail-retained gastrostomy [PG] vs mushroom-retained gastrostomy [MG]).
Between March 2014 and February 2016, 100 patients were randomly assigned to receive 14-F PG or 20-F MG. Block randomization (block size 4) was performed, and sample size was calculated to assess the difference in minor complications. One patient withdrew from the study after allocation. Baseline characteristics were not significantly different between groups (P > .05). Technical success, defined as successful placement of gastrostomy tube, and procedural complications were evaluated. Procedural complications were divided into major and minor complications according to the Society of Interventional Radiology criteria.
Technical success rate was 100%. In the PG group, the major complication rate was 2% (1 of 50); 1 patient had a misplaced PG in the peritoneal cavity between the gastric and abdominal walls and developed peritonitis that had to be surgically treated. The minor complication rate was 34% (17 of 50) in the PG group. In the MG group, the major complication rate was 0%, and the minor complication rate was 12.2% (6 of 49). The most common minor complication was tube occlusion. Minor complication rate was significantly higher in the PG group (P = .016). Mean fluoroscopy time was significantly longer in the MG group (P = .013).
Both PG and MG demonstrated high technical success rates in all indications. MG had lower complication rates than PG at the cost of an increase in fluoroscopy times.
前瞻性比较两种不同类型的经皮透视下胃造口术（猪尾型胃造口术[PG]与蘑菇型胃造口术[MG]）。
2014年3月至2016年2月期间，100例患者被随机分配接受14-F的PG或20-F的MG。采用区组随机化（区组大小为4），并计算样本量以评估轻微并发症的差异。1例患者在分配后退出研究。两组间基线特征无显著差异（P>.05）。评估技术成功率（定义为胃造口管成功置入）和手术并发症。根据介入放射学会标准，将手术并发症分为主要并发症和轻微并发症。
技术成功率为100%。在PG组中，主要并发症发生率为2%（50例中的1例）；1例患者的PG误置于胃壁和腹壁之间的腹腔内并发生腹膜炎，需手术治疗。PG组的轻微并发症发生率为34%（50例中的17例）。在MG组中，主要并发症发生率为0%，轻微并发症发生率为12.2%（49例中的6例）。最常见的轻微并发症是导管堵塞。PG组的轻微并发症发生率显著更高（P =.016）。MG组的平均透视时间显著更长（P =.013）。
PG和MG在所有适应症中均显示出较高的技术成功率。MG的并发症发生率低于PG，但代价是透视时间增加。
