Mushroom Gastrostomy

Gastrostomy is performed by surgeons, gastroenterologists, and interventional radiologists. Compared with surgical methods, percutaneous routes tend to have slightly lower complication rates and are generally preferred in many hospitals. Percutaneous fluoroscopic gastrostomy can be performed using a variety of methods reflecting the varying retention mechanisms of different catheters. Although both pigtail and balloon-retained gastrostomy catheters are the easiest to insert, both tubes suffer from poor long-term patency and are less secure than mushroom-retained catheters. These latter tubes are the most durable and best catheters in terms of overall performance. In my hospital, mushroom-retained tubes are the tubes of choice except in patients with high-grade oropharyngeal or esophageal obstruction.

REFERENCES

• 1 Szymski G X, Albazzaz A N, Funaki B et al.. Radiologically guided placement of pull-type gastrostomy tubes.  Radiology. 1997;  205 669-673
• 2 Funaki B, Zaleski G X, Lorenz J et al.. Radiologic gastrostomy placement: pigtail- versus mushroom-retained catheters.  AJR Am J Roentgenol. 2000;  175 375-379
• 3 Funaki B, Peirce R, Lorenz J et al.. Comparison of balloon- and mushroom-retained large-bore gastrostomy catheters.  AJR Am J Roentgenol. 2001;  177 359-362
• 4 Yip D, Vanasco M, Funaki B. Complication rates and patency of radiologically guided mushroom gastrostomy, balloon gastrostomy, and gastrojejunostomy: a review of 250 procedures.  Cardiovasc Intervent Radiol. 2004;  27 3-8