Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic Gastrostomy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Baseline Assessment and Preparatory Measures
2.2. CT-Guided PRG Techniques at the Two Study Sites
2.2.1. Group 1 (MS-CT BM and Retention Anchor Suture)
2.2.2. Group 2 (RT-CTF and Gastropexy Device)
2.3. Follow-Up
2.4. Data Evaluation
2.5. Statistical Analysis
3. Results
3.1. Study Population
3.2. Interventional Parameters
3.3. Outcome
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Center 1 | Center 2 | |
---|---|---|
Staff present | 1 × interventionalist, radiographer, interventional radiology nurse | |
Preparation | ||
Required lab values | INR ≤ 1.5, Quick ≥ 60%, Hb ≥ 80g/L, platelate value ≥ 50 × 109/L | INR ≤ 1.5, Quick ≥ 50%, aPTT < 50 s, platelate value ≥ 50 × 109/L |
Drugs during intervention | Lidocaine 1% (max. 20 mL), 20 mg Buscopan | Lidocaine 1%, 5 mg Midazolam, 8 mg Ondansetron and 15 mg Piritramid, if necessary (Buscopan 20 mg) |
Stomach insufflated volume | 600 mL (room air) | 800 mL (room air) |
Scanner | ||
Type | Toshiba Asteion 4SL/Somatom X.cite | Somatom Definition AS |
Mode | MS-CT BM | RT-CTF |
Name | i-Sequence | i-Fluoro |
CTF | intermittent | continuous |
Acquired slices | 3 × 4 mm | 1 × 5 mm |
Tube settings | 120 kV, 25 mAs, rotation time 0.5 s | 100 kV, 40 mAs, rotation time 0.36 s |
Operator experience | board-certified radiologist and at least one year of experience in this procedure | |
Material | ||
Gastric tube | Flocare® Gastro Tube CH 14 | Freka® Pexact CH/FR 15 |
Fixation material | 4 × single anchors | gastropexy device |
Fixation technique | Free choice of anchor number, min 1. | 4 point with 2 sutures, distance to each of 2 cm |
Dilatation | Enteral Access Dilation System 12–16 F | several, single dilatators 10, 12 and 16 F |
Additional material | metalline® aluminum vaporized coating compress | Slit compress |
Start of nutrition | early feeding 6 h after intervention |
Survey of PRG | |||||||
---|---|---|---|---|---|---|---|
Parameter | All (n = 100) | C1, MS-CT BM with Single Anchor (n = 50) | C2, RT-CTF with Gastropexy Device (n = 50) | p Value | |||
Female | 27 | 27% | 14 | 28% | 13 | 26% | 1.000 |
Age (y) | 62.52 | ±12.36 | 62.52 | ±12.36 | 64.18 | ±12.44 | 0.288 |
Indication | 0.011 * | ||||||
HN-cancer | 80 | 80% | 35 | 70% | 45 | 90% | |
Neurological disorders | 14 | 14% | 12 | 24% | 2 | 4% | |
Other indications | 6 | 6% | 3 | 6% | 3 | 6% | |
DLP of CTF (mGy×cm) | 43.59 | ±53.10 | 56.28 | ±67.897 | 30.91 | ±27.539 | <0.001 * |
Exposure Time (s) | 11.63 | ±12.86 | 5.88 | ±5.618 | 16.69 | ±15.183 | <0.001 * |
Proportion of CTF DLP to total DLP | 0.13 | ±0.12 | 0.12 | ±0.134 | 0.14 | ±0.111 | 0.011 * |
No. of CT | 2.31 | ±1.71 | 3.42 | ±1.797 | 1.20 | ±0.404 | <0.001 * |
DLP of CTs (mGy×cm) | 390.43 | ±545.82 | 582.37 | ±714.3 | 198.50 | 128.54 | <0.001 * |
Total DLP (mGy×cm) | 462.90 | ±582.92 | 681.00 | ±751.49 | 244.62 | ±156.74 | <0.001 * |
GT (min) | 11.14 | ±5.725 | 11.50 | ±5.239 | 11.17 | ±6.015 | 0.463 |
Procedure time (min) | 35.74 | ±21.27 | 41.08 | ±16.97 | 30.40 | ±23.83 | <0.001 * |
Complications | 0.458 | ||||||
Minor | 19 | 19% | 7 | 14% | 12 | 24% | |
Major | 2 | 2% | 1 | 2% | 1 | 2% |
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Brönnimann, M.P.; Tarca, M.; Segger, L.; Kulagowska, J.; Fleckenstein, F.N.; Gebauer, B.; Fehrenbach, U.; Collettini, F.; Heverhagen, J.T.; Auer, T.A. Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic Gastrostomy. Tomography 2024, 10, 1754-1766. https://doi.org/10.3390/tomography10110129
Brönnimann MP, Tarca M, Segger L, Kulagowska J, Fleckenstein FN, Gebauer B, Fehrenbach U, Collettini F, Heverhagen JT, Auer TA. Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic Gastrostomy. Tomography. 2024; 10(11):1754-1766. https://doi.org/10.3390/tomography10110129
Chicago/Turabian StyleBrönnimann, Michael P., Mauro Tarca, Laura Segger, Jagoda Kulagowska, Florian N. Fleckenstein, Bernhard Gebauer, Uli Fehrenbach, Federico Collettini, Johannes T. Heverhagen, and Timo A. Auer. 2024. "Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic Gastrostomy" Tomography 10, no. 11: 1754-1766. https://doi.org/10.3390/tomography10110129
APA StyleBrönnimann, M. P., Tarca, M., Segger, L., Kulagowska, J., Fleckenstein, F. N., Gebauer, B., Fehrenbach, U., Collettini, F., Heverhagen, J. T., & Auer, T. A. (2024). Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic Gastrostomy. Tomography, 10(11), 1754-1766. https://doi.org/10.3390/tomography10110129