GASTROSTOMY

General Information

DEFINITION--An opening into the stomach.

BODY PARTS INVOLVED--Stomach; skin; structures of the abdominal wall.

REASONS FOR SURGERY--To provide an external opening for feeding or for drainage. When performed for drainage, it's to bypass long-standing or progressive obstruction of the stomach outlet into the intestine, as with scarring from a peptic ulcer or a tumor. It's performed for feeding when oral feeding is not feasible for long periods of time.

SURGICAL RISK INCREASES WITH

• Stress; obesity; poor nutrition; smoking.
• Excess alcohol consumption.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--General surgeon.

WHERE PERFORMED--Hospital or outpatient surgical facility.

DIAGNOSTIC TESTS--Before surgery: Blood and urine studies; x-rays of gastrointestinal tract; endoscopy (See Glossary).

ANESTHESIA--Usually local with standby general anesthesia.

DESCRIPTION OF OPERATION

• An incision is made in the abdominal wall.
• The stomach is isolated and an opening is made into it.
• The tube (usually polyvinylchloride or rubber) is secured by sutures around it to hold it in place.
• The other end of the tube is pulled to the outside through the incision site.
• The procedure may also be accomplished with gastroscopy (see Gastrostomy, Percutaneous Endoscopic in Surgery section).

POSSIBLE COMPLICATIONS

• Skin irritation around the gastrostomy tube.
• Tube dislodgment.
• Cramping, bloating, nausea, diarrhea.

AVERAGE HOSPITAL STAY--1 day or may be performed as an outpatient.

PROBABLE OUTCOME--Good results to maintain nutrition or provide drainage if obstructed.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the likelihood of deep--vein blood clots.

† You may use non--

prescription drugs, such as acetaminophen, for minor pain.

• Avoid aspirin.

ACTIVITY---Resume normal activity as soon as possible to promote healing.

DIET

• Your doctor will prescribe a diet.
• Vitamin and mineral supplements (sometimes).

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience nausea, vomiting, constipation or abdominal swelling.