gastrostomie

Gastrostomie, also called gastrostomy in English, is a medical procedure that creates a direct opening from the skin into the stomach (a stoma) to enable long‑term enteral feeding. Through this opening, a feeding tube is placed and remains in place for weeks to months, and sometimes permanently, depending on the underlying condition.

Indications for a gastrostomie include inability to swallow safely or take sufficient nutrition by mouth for an extended period, due to neurological disorders (such as stroke, ALS, or advanced dementia), neuromuscular diseases, head and neck cancer, severe oropharyngeal disease, or other conditions that impair oral intake or increase aspiration risk. It is considered when noninvasive feeding methods are unsuitable or impractical and when maintaining adequate nutrition is necessary for recovery, comfort, or quality of life.

The main techniques are percutaneous endoscopic gastrostomy (PEG), radiologically inserted gastrostomy (RIG), and surgical gastrostomy. PEG uses endoscopic guidance to place the tube through the abdominal wall into the stomach, typically under local anesthesia with sedation. RIG is performed with imaging guidance (fluoroscopy or CT). Surgical gastrostomy may be open or laparoscopic, used when endoscopic or radiologic access is not feasible.

Gastrostomy tubes may be standard parenteral tubes or low‑profile buttons designed for long‑term use. Postoperative care includes regular tube care, flushed administration of feeds or medications, and monitoring for infection, skin irritation, or tube dislodgement. Complications can be early (bleeding, infection, peritonitis) or late (tube blockage, granulation tissue, fistula formation). Overall outcomes depend on underlying health and indication.