De novo placement of button gastrostomy catheters in an adult population: experience in 53 patients

J Vasc Interv Radiol. 2003 Oct;14(10):1283-9. doi: 10.1097/01.rvi.0000092901.73329.eb.


Purpose: To investigate the feasibility of primary button gastrostomy insertion with the aid of T-fastener gastropexy.

Materials and methods: Fifty-three consecutive patients (33 men, 20 women; mean age, 63.4 years) referred for percutaneous radiologic gastrostomy (PRG) underwent primary button gastrostomy insertion over an 18-month period in two centers. Nine of the patients (17%) were referred after failed endoscopic gastrostomy and 44 (83%) were primarily referred for PRG. Indications for gastrostomy included esophageal/head and neck malignancy (n = 33) and neurologic disorders (n = 20). Gastropexy with three or four T-fasteners was performed in all patients and angioplasty balloon catheters (6 mm x 40 mm) were used to measure tract length and dilate the tract. An 18-F dilator was used for final tract dilation. Button gastrostomy catheters with retention balloons were inserted in all patients. Patient follow-up was performed by the department of dietetics, which contacted patients on a weekly basis.

Results: Primary button gastrostomy insertion was successful in 52 of 53 patients (98%). The mean gastrostomy button catheter survival was 13.3 weeks (range, 1-28 weeks). No episodes of button occlusion occurred. Since the beginning of this study, 33 patients (63%) have had their gastrostomy buttons replaced. The reasons for button replacement include burst retention balloons (n = 27; 52%), dislodgment of the catheter (n = 4; 8%), and continuing pain/discomfort at the gastrostomy site (n = 2; 4%).

Conclusion: Button-type gastrostomy catheters can be placed de novo by interventional radiologists without the need for a mature tract, provided a T-fastener gastropexy is used. The balloon retention button devices are not compromised by occlusion but do tend to become dislodged.

MeSH terms

  • Adult
  • Enteral Nutrition
  • Female
  • Gastrostomy / instrumentation
  • Gastrostomy / methods*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Radiography, Interventional*