Kuc Norbert, Feldman Ariel, Small Ilan, Cynamon Jacob, Gohari Arash
Montefiore Medical Center, The Bronx, USA.
Albert Einstein College of Medicine, The Bronx, USA.
Abdom Radiol (NY). 2025 Apr 30. doi: 10.1007/s00261-025-04962-4.
To compare the safety and efficacy of balloon-assisted gastrostomy (BAG) placement to the conventional serial dilation technique.
This study is an IRB-approved retrospective review of all percutaneous gastrostomy tubes placed by an interventional radiology department at a single institution between 2012 and 2021. There were 476 patients identified (average age 63, 44% female): 385 in the serial dilation group and 91 in the balloon assisted gastrostomy (BAG) group. Patient demographic, procedure, and radiological data were reviewed in the medical record to determine procedure success, procedure/fluoroscopy time, and tube failures. Gastrostomy tube failure was defined as tube leak, clogging, or dislodgement. Adverse events were classified as per Society of Interventional Radiology guidelines. Statistical analysis was performed using Fisher's exact test, student's t-test, and Mann-Whitney U-test as appropriate.
Gastrostomy tubes were successfully placed in 97.7% (377/385) of patients undergoing the serial dilation technique and 100% (91/91) of patients undergoing the BAG placement technique. BAG tube placement was associated with a 2.5 min decrease (47%) in average fluoroscopy time (p = 0.0002, CI: 3.76 to 1.20). Total procedure time was reduced by an average of 17.2 min (22%) (p = 0.0006, CI: 26.9 to 7.4). BAG was also associated with an 11% reduction in all cause gastrostomy tube failure (p = 0.0399). There were no statistically significant differences in the adverse event rates or median days to tube failure. Material costs were $178.32 higher in the BAG group.
BAG catheter placement can be performed safely and effectively, and is associated with reduced fluoroscopy time, procedure time, and overall failure rate compared to the serial dilation technique.
比较球囊辅助胃造口术（BAG）置管与传统序贯扩张技术的安全性和有效性。
本研究是一项经机构审查委员会批准的回顾性研究，回顾了2012年至2021年期间一家机构的介入放射科所放置的所有经皮胃造口管。共确定了476例患者（平均年龄63岁，44%为女性）：序贯扩张组385例，球囊辅助胃造口术（BAG）组91例。查阅病历中的患者人口统计学、手术和放射学数据，以确定手术成功率、手术/透视时间和造口管失败情况。胃造口管失败定义为管道渗漏、堵塞或移位。不良事件按照介入放射学会指南进行分类。根据情况使用Fisher精确检验、学生t检验和Mann-Whitney U检验进行统计分析。
序贯扩张技术组97.7%（377/385）的患者胃造口管成功置入，球囊辅助胃造口术（BAG）置管技术组100%（91/91）的患者成功置入。BAG置管与平均透视时间减少2.5分钟（47%）相关（p = 0.0002，置信区间：3.76至1.20）。总手术时间平均减少17.2分钟（22%）（p = 0.0006，置信区间：26.9至7.4）。BAG还与所有原因导致的胃造口管失败率降低11%相关（p = 0.0399）。不良事件发生率或造口管失败的中位天数无统计学显著差异。BAG组的材料成本高178.32美元。
与序贯扩张技术相比，BAG导管置管操作安全有效，且透视时间、手术时间和总体失败率均降低。
