Percutaneous radiologic gastrostomy with single gastropexy using balloon-assisted tract dilatation: comparison with peel-away sheath

PURPOSE To evaluate the safety and efficacy of percutaneous radiologic gastrostomy (PRG) with balloon-assisted tract dilatation (BATD) using a single gastropexy. METHODS This retrospective study was approved by the institutional review board. From August 2018 to October 2022, 61 patients (53 male and 8 female, mean age 67 years, age range 27-90 years) underwent PRG with balloon-retained tubes for enteral nutrition. Single gastropexy was performed in all cases. Patients were divided into two groups based on the tract dilatation technique used. In the first group, BATD (n = 48) was performed. In the second group, a 24-Fr peel-away sheath (PAS) was used for tract dilatation (n = 13). Patient demographics, technical success rate, clinical success rate, fluoroscopy time, cumulative radiation dose, and complications were retrospectively evaluated. The Mann-Whitney U test for continuous variables and Fisher's exact test for categorical variables were performed to compare the two groups. RESULTS All procedures were successfully performed with 100% technical and clinical success rates in both groups. The mean fluoroscopy time for the BATD group vs. the PAS group (1.68 +/- 0.93 min vs. 3.56 +/- 2.41 min, P < 0.001) and mean cumulative radiation dose (12.98 +/- 9.28 mGy vs. 33.01 +/- 15.14 mGy, P < 0.001) were significantly lower in the BATD group compared with the PAS group. There was one major complication of peritonitis that led to death in the PAS group (1/13, 7.7%) and no major complications in the BATD group. Minor complications such as pneumoperitoneum, abdominal pain, leakage, and balloon deflation occurred in 16 patients: 12 (12/48, 25.0%) patients in the BATD group and 4 (4/13, 38.5%) patients in the PAS group. The overall rate of major and minor complications was higher in the PAS group but did not show statistically significant differences (odds ratio: 1.875, 95%; confidence interval: 0.514-6.841, P = 0.486). CONCLUSION BATD using a single gastropexy is a safe and effective technique for PRG.