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

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.

Publication History

Article published online:
19 March 2021