A simple and inexpensive method of removal or replacement of gastrostomy tubes.

The safety of removal or replacement of gastrostomy tubes by simply cutting the tube and allowing the inner components to be eliminated intestinally was prospectively studied in 64 patients. In only one patient was the internal component lodged at the pylorus; it required endoscopic removal. Abdominal radiographs obtained in 57 patients confirmed complete elimination of internal percutaneous endoscopic gastrostomy components in 48 patients (84%) and identified these components in the colon in eight (14%). In two patients, the internal components were identified in the stool, and in one, radiographs were not obtained. Six patients who did not have abdominal radiographs had no problems during a mean follow-up period of 153.3 +/- 37.2 days. This simple method is safe, inexpensive, can be offered to the large majority of patients with percutaneous endoscopic gastrostomy tubes, and avoids the need for endoscopic removal.