T-Fastener Migration after Percutaneous Gastropexy for Transgastric Enteral Tube Insertion.
- Author:
Ryan H SYDNOR
1
;
Stacey M SCHRIBER
;
Charles YOON KIM
Author Information
- Publication Type:Original Article
- Keywords: T-fasteners; Gastropexy; Gastrostomy tube; Gastrojejunostomy tube
- MeSH: Abdominal Wall/surgery; Enteral Nutrition; Female; Foreign-Body Migration/complications/*epidemiology; Gastropexy/adverse effects/*instrumentation; Humans; *Intubation, Gastrointestinal; Male; Middle Aged; Retrospective Studies; *Surgical Fixation Devices/adverse effects; Time Factors
- From:Gut and Liver 2014;8(5):495-499
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: To determine the prevalence and time-course of t-fastener migration after gastropexy deployment. METHODS: We reviewed our procedural database for all percutaneous gastrostomy and gastrojejunostomy tube insertions performed over a 14-month period using a widely accepted t-fastener kit for gastropexy (Kimberly-Clark). Of 201 patients, 71 (41 males, 30 females; mean age, 56 years) underwent subsequent abdominal computed tomography (CT) imaging. The location and associated findings of each t-fastener were retrospectively recorded for each CT scan performed after the tube insertion. RESULTS: A total of 153 t-fasteners were deployed during 71 procedures with subsequent CT follow-up. In the short term (within 4 weeks after deployment), 5.1% of the t-fasteners had detached and were no longer present; 59.5% were intraluminal or within the gastric wall; and 35.5% were within the anterior abdominal wall musculature or subcutaneous. In the long term (>3 months), 48.6% of the t-fasteners had detached and were no longer present, 25.0% were intraluminal or within the gastric wall, and 26.4% were within the anterior abdominal wall musculature or subcutaneous. No t-fastener-related complications, such as abscesses, fluid collections, or fistulae, were identified. CONCLUSIONS: Following gastropexy for percutaneous transgastric feeding tube placement, t-fastener migration into the abdominal wall frequently occurred soon after the tube insertion. Therefore, recent t-fastener deployment does not guarantee an intact gastropexy.
