The One-Anchor Technique of Gastropexy for Percutaneous Radiologic Gastrostomy: Results of 248 Consecutive Procedures

Purpose: To evaluate the safety and efficacy of the one-anchor technique of gastropexy for percutaneous radiologic gastrostomy (PRG). Materials and Methods: A total of 248 PRG procedures with the one-anchor technique were attempted in 242 consecutive patients between January 2000 and June 2006. For gastropexy, a single anchor was used and gastrostomy tube placement was performed through the same tract of the anchor with a 10-16-F Wills-Oglesby gastrostomy catheter. Technical success, complications, and anchor dislodgments were evaluated by means of review of imaging studies and patient medical records. Results: Among 248 procedures, PRG with the one-anchor technique was performed successfully in 247 procedures, with one procedural failure (99.6% successful placement rate). Fourteen-day follow-up data were available for 216 patients (87%). There were 11 major complications (5.1%), including peritonitis (n = 5), bleeding (n = 4), infection requiring tube removal (n = 1), and gastrocolic fistula (n = 1); and 31 minor complications (14.4%), including tube malfunction (ie, dislodgment, occlusion, breakage; n = 26), oozing (n = 4), and infection (n = 1). There were 25 anchor dislodgments, including breakdown of the string of the anchor during the procedure (n = 5), early release of the anchor within 1 week (n = 9), migration into the peritoneal space (n = 8), and expulsion out of the body (n = 3). Four major complications and one failure were directly related to anchor dislodgment. Conclusions: PRG with the one-anchor technique is a feasible procedure. However, anchor dislodgments are relatively common, and these are related to major complications such as peritonitis and bleeding.