An expanding role for interventional radiology: Medicare trends in fluoroscopic, endoscopic, and surgical enteric tube placement and maintenance from 2010 to 2018

García, Ricardo Pardo; Lindquester, Will S.; Dhangana, Rajoo; Warhadpande, Shantanu; Amesur, Nikhil B.

doi:10.1016/j.clinimag.2021.05.008

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…Future studies assessing the outcomes of infracolic gastrostomies must be done to definitively determine whether this technique compares to the traditional supracolic method before advocating for interventional radiologists to attempt to place infracolic gastrostomies. Sana Rashid, 1 Harun Jalil, 2 Alaaeldin Ginawi, 2 Oleg Mironov, 1,3 Syed Umair Mahmood Authors' Contribution S.R. contributed to literature search and primary writeup.…”

Section: Discussionmentioning

confidence: 99%

“…1 When compared with endoscopic or surgical gastrostomies, PRG has a higher rate of successful tube placement and lower rate of complications, thus making it a valuable alternative to these methods. 2,3 PRG is conventionally done using a supracolic approach where the location of the colon is first delineated using an ultrasound or barium swallow the day prior to the procedure. 4 The stomach is then punctured above the colon using fluoroscopic guidance to avoid injury to adjacent structures.…”

Section: Introductionmentioning

confidence: 99%

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A Literature Review of Infracolic Gastrostomy Techniques and Outcomes

Rashid,

Jalil,

Ginawi

et al. 2023

The Arab Journal of Interventional Radiology

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Percutaneous radiologic gastrostomies are traditionally done using a supracolic approach due to the perceived increased risk of postprocedural hemorrhage associated with an infracolic approach. Many interventional radiologists will decline attempts at placing a gastrostomy tube in situations of colonic interposition, requiring patients to undergo surgery. The goal of this review was to understand the safety and technique of infracolic gastrostomies to assess the validity of these concerns. There were 12 cases of infracolic gastrostomies identified across two retrospective studies and one case report. All gastrostomy tubes were inserted successfully with no abandoned procedures with the only minor variation in technique being that the colon was displaced superiorly as opposed to inferiorly like in the traditional supracolic approach. Across the two retrospective studies, the percentage of infracolic gastrostomies done during the study period was 1.18% (6 out of 508) and 0.43% (5 out of 1,156). There were no immediate postprocedural complications reported in the study done with six patients who underwent infracolic gastrostomies, but there were two deaths during the follow-up period, both of which were attributed to disease progression. In the study with five patients who had undergone infracolic gastrostomies, there was one minor complication of site soreness along with one case of death due to sepsis secondary to aspiration of the barium contrast used to delineate the colon prior to the procedure. This is a rare complication that can occur when a barium swallow is done, especially in this case where the patient was older and had comorbidities that increased the aspiration risk. Evidently, infracolic gastrostomies have been inserted in the past with minimal complications. However, due to the limited sample size, the safety of this technique cannot be established without future prospective studies.

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