Feeding gastrostomy: a reappraisal.

A retrospective review of 67 patients undergoing feeding gastrostomy for nutritional support over a ten-year period disclosed a 30 day mortality rate of 30 per cent following this procedure. Patients with head and neck carcinoma and those patients who were not in coma at the time of the procedure enjoyed extended and useful long-term survival. Patients who were in coma at the time of the procedure had similar mortality rates, but no patient ever regained consciousness afterward despite survival times of over one year. It is our conclusion that feeding gastrostomy in comatose patients is a questionable procedure and one which is unlikely to benefit the patient. It would appear that the only present day rationale for the performance of a feeding gastrostomy in comatose patients lies in the facilitation of their nursing care and their transfer to a chronic care facility.