Safety and efficacy of stoma site selection in CT-guided percutaneous gastrostomy: a retrospective analysis.

Abstract

To compare the safety and efficacy of CPG in the rectus abdominis and intercostal regions. This retrospective study included 226 patients who underwent CPG at a single center, with the stoma placed in the rectus abdominis or intercostal region. Surgical outcomes and complications, such as pain and infection within 6months postoperatively, were recorded. The surgical success rate was 100%, and the all-cause mortality rate within 1month was 0%. An intercostal stoma was placed in 56 patients; a rectus abdominis stoma was placed in 170 patients. The duration of surgery was longer for intercostal stoma placement (37.66 ± 14.63min) than for rectus abdominis stoma placement (30.26 ± 12.40min) (P = 0.000). At 1month postsurgery, the rate of stoma infection was greater in the intercostal group (32.1%) than in the rectus abdominis group (20.6%), but the difference was not significant (P = 0.077). No significant difference was observed in the infection rate between the two groups at 3 or 6months postsurgery (P > 0.05). Intercostal stoma patients reported higher pain scores during the perioperative period and at 1month postsurgery (P = 0.000), but pain scores were similar between the two groups at 3 and 6months postsurgery. The perioperative complication rates for intercostal and rectus abdominis surgery were 1.8% and 5.3%, respectively (P = 0.464), with no significant difference in the incidence of tube dislodgement (P = 0.514). Patient weight improved significantly at 3 and 6months postoperatively compared to preoperatively (P < 0.05). Rectus abdominis and intercostal stomas have similar safety and efficacy. However, intercostal stomas may result in greater short-term patient discomfort.