Gastrostomy “Button” Diameter And Length Variations After Percutaneous Endoscopic Gastrostomy: One Size Does Not Fit All

V Macedo Silva; M Freitas; R Sousa Magalhães; T Cúrdia Gonçalves; P Boal Carvalho; C Marinho; J Cotter

doi:10.1055/s-0041-1724645

Endoscopy, Table of Contents

Endoscopy 2021; 53(S 01): S145
DOI: 10.1055/s-0041-1724645

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Gastrostomy “Button” Diameter And Length Variations After Percutaneous Endoscopic Gastrostomy: One Size Does Not Fit All

Authors

V Macedo Silva

¹Hospital da Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal

²School of Medicine - University of Minho, Life and Health Sciences Research Institute (ICVS), Braga, Portugal

³ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
M Freitas

¹Hospital da Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal

²School of Medicine - University of Minho, Life and Health Sciences Research Institute (ICVS), Braga, Portugal

³ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
R Sousa Magalhães

¹Hospital da Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal

²School of Medicine - University of Minho, Life and Health Sciences Research Institute (ICVS), Braga, Portugal

³ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
T Cúrdia Gonçalves

¹Hospital da Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal

²School of Medicine - University of Minho, Life and Health Sciences Research Institute (ICVS), Braga, Portugal

³ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
P Boal Carvalho

¹Hospital da Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal

²School of Medicine - University of Minho, Life and Health Sciences Research Institute (ICVS), Braga, Portugal

³ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
C Marinho

¹Hospital da Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal

²School of Medicine - University of Minho, Life and Health Sciences Research Institute (ICVS), Braga, Portugal

³ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
J Cotter

¹Hospital da Senhora da Oliveira, Gastroenterology Department, Guimarães, Portugal

²School of Medicine - University of Minho, Life and Health Sciences Research Institute (ICVS), Braga, Portugal

³ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal

Abstract

Full Text

Aims Percutaneous endoscopic gastrostomy (PEG) is a useful option for long-term enteral nutrition in patients without an efficient oral intake. Low-profile gastrostomy tubes (“buttons”) may afterwards be placed in the stomach through the abdominal wall following maturation of the pre-existing stoma, usually 6-12 months after the initial procedure. Regular button verification is essential, since inadequate sizing may be associated with accidental exteriorization or food leakage through the stoma. We aimed to evaluate gastrostomy button diameter or length variations on the first year after its placement. A secondary outcome was to identify possible factors associated with these variations.

Methods We analyzed consecutive PEGs between 2016 and 2018. A minimum follow-up of 24 months was required (12 months until button placement and additional 12 months for evaluation of button changes). Button diameter or length variations were assessed in a specialized PEG appointment during the follow-up period. Variables possibly associated with this outcome were tested.

Results From 150 procedures, 56 were excluded by not having the required follow-up period. Final sample consisted of 65 (69.1 %) women, with a mean age of 76.9 years. Button diameter or length variations occurred in 44 (46.8 %) patients. On multivariate analysis, diameter reduction was significantly more frequent in nursing homes patients (OR=5.56; 95 %CI=1.33-22.22, p=0.019) or with accidental exteriorization of the gastrostomy tube (OR=3.85; 95 %CI=1.22-12.19, p=0.02). Length variation occurred more frequently in patients with a weight change greater than 5 kilograms (either gain or loss) (OR=3.70; 95 %CI=1.15-12.05, p=0.029).

Conclusions A significant proportion of patients with gastrostomy buttons eventually required a change in their length or diameter, especially if living in nursing homes, having significant weight changes or reporting accidental tube exteriorization. This emphasizes the importance of having a specialized PEG appointment in order to regularly assure the best fitted button for each patient and ultimately guarantee an adequate nutritional intake.

Citation Macedo Silva V, Freitas M, Sousa Magalhães R et al. eP149 GASTROSTOMY “BUTTON” DIAMETER AND LENGTH VARIATIONS AFTER PERCUTANEOUS ENDOSCOPIC GASTROSTOMY: ONE SIZE DOES NOT FIT ALL. Endoscopy 2021; 53: S145.