During 1985-2014 in our Clinic nearly 4,925 gastrostomes were performed, for a large variety of pathologies: benign and malign esophageal stenosis, esophageal fistulas, posttraumatic ruptures, iatrogenic pathology, strokes. Among those, some were definitives and the others were temporary. We used Gavriliu technique with peritoneal collar in 96% of the cases. During those 30 years we managed to establish an immediate and long-term care protocol of the feeding gastrostomes. This protocol contains specific measures for the monitoring of the vital parameters, biological and metabolical ones, but also the close analysis of the gastric stasis, the imposing of the digestive repose during the first 48-72 hours, the continue follow-up of the quality and the rhythm of alimentation and the mechanical protection of the Pezzer tube. The efficiency of this type of nursing consists in the introduction of food after 48-72 hours, with the second stage of efficiency of the gastrostomy in the same time with the long-term care of the associated oncological and metabolical complications. Due to the importance of the moment of the surgical indication, the technique and nursing that has been used, the survival of the patient with definitive gastrostomy has significantly improved. The elimination of the temporary ones didn’t involve in most of the cases surgical closing.