Safety and Efficacy of Stoma Site Selection in CT-guided Percutaneous Gastrostomy: A Retrospective Analysis

Abstract Purpose: To compare the safety and efficacy of CPG in the rectus abdominis and intercostal regions. Materials and Methods: This retrospective study included 226 patients who underwent CPG at a single center, with the stoma placed in the rectus abdominis or intercostal region. Surgical outcomes and complications, such as pain and infection within 6 months postoperatively, were recorded. Results: The surgical success rate was 100%, and the all-cause mortality rate within one month was 0%. An intercostal stoma was placed in 56 cases, while a rectus abdominis stoma was placed in 170 cases. The duration of surgery was longer for intercostal stoma placement (37.66 ± 14.63 min) than for rectus abdominis stoma placement (30.26 ± 12.40 min) (p=0.000). At one month postoperatively, the rate of stoma infection was higher in the intercostal group (32.1%) than in the rectus abdominis group (20.6%), but the difference was not significant (P=0.077). No significant difference was observed in the infection rate between the two groups at three or six months postoperatively (P>0.05). Intercostal stoma patients reported higher pain scores during the perioperative period and at one month postoperatively (P=0.000), but pain scores were similar in the two groups at three and six months postoperatively. The perioperative complication rate for intercostal and rectus abdominis surgery was 1.8% and 5.3%, respectively (P=0.464), with no significant difference in the incidence of tube dislodgement (P=0.514). Patient weight was significantly improved at three and six months postoperatively compared to preoperatively (P<0.05). Conclusion: Both rectus abdominis and intercostal stomas show similar levels of safety and efficacy. However, intercostal stomas may result in greater short-term patient discomfort.