Gut Liver.  2014 Sep;8(5):495-499. 10.5009/gnl13204.

T-Fastener Migration after Percutaneous Gastropexy for Transgastric Enteral Tube Insertion

• Sydnor RH
• Schriber S
• Yoon Kim C

• KMID: 2070059
• DOI: http://doi.org/10.5009/gnl13204

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.

Keyword

T-fasteners; Gastropexy; Gastrostomy tube; Gastrojejunostomy tube

MeSH Terms

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