Clinical comparative analysis of percutaneous gastrostomy guided by different imaging techniques / 中华临床营养杂志

ABSTRACT

Objective To investigate the clinical characteristics of percutaneous gastrostomy guided by different imaging techniques,in an effort to inform selection of imaging guidance.Methods A retrospective analysis was conducted on the clinical data of 277 patients who underwent percutaneous gastrostomy at Affiliated Tumor Hospital of Zhengzhou University from January 2014 to December 2016.The patients were divided into three groups according to the imaging techniques used,i.e.group A guided by fluoroscopy of digital subtraction angiography (DSA),group B by C-arm computed tomography (CT),and group C by CT throughout the process.The technical success rate,complication rate,operation time and patient's radiation dose were compared among the three groups.Results There was no siguificant difference in technical success rate (93.8％vs.97.3％ vs.100％,x2=2.797,P=0.247) and complication rate (10.0％ vs.11.3％ vs.20.0％,x2=1.343,P=0.511) among the 3 groups,but the operation time [(25.57±5.99) min vs.(29.01±6.63) min vs.(45.47±8.98) min,x2 =27.977,P＜0.001] and patient's radiation [(27.30± 19.27) mGy vs.(145.07±106.08) mGy vs.(2 590.26±1 088.22) mGy,x2 =204.444,P＜0.001] dose were significantly different (x2=87.977,P＜0.001;x2=204.444,P＜0.001),with group A and B lower than group C (P＜ 0.001) and group A lower than group B (P≤0.001).Conclusions DSA fluoroscopic guidance should be the first choice for percutaneous gastrostomy,but before the operation,abdominal CT scan should be performed to exclude such situations as hypertrophy of left lobe of liver,and colon in front of the stomach.If the DSA machine is equipped with C-arm CT function,the surgery can also be directly guided by C-arm CT.Complete CT guidance can be used as a supplement in the case of failure by both DSA fluoroscopy and C-arm CT guidance.