The antireflux feeding gastrostomy: an improved method.

For patients who are not able to maintain nutrition by normal oral feeding, the choices of nutritional support can be parenteral, enteral, or gastric. Very little has been written in recent surgical literature about permanent feeding gastrostomies. Dissatisfaction with the conventional Stamm and Witzel gastrostomies prompted the authors to devise an improved method that creates a stapler-constructed, proximally based, antral gastric tube with an antireflux valve made by imbricating the gastric wall around the base of the gastric tube. Forty such procedures done between 1982 and 1984 were reviewed.When properly constructed, this antireflux feeding gastrostomy has the distinct advantage of being physiologic, economical, and easy to maintain for long-term use. If the patient recovers to the point of no longer needing the feeding gastrostomy, the tube stoma can be closed easily under local anesthesia.