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https://www.readbyqxmd.com/read/28301921/health-care-utilization-and-complications-of-endoscopic-esophageal-dilation-in-a-national-population
#1
Abhinav Goyal, Kshitij Chatterjee, Sujani Yadlapati, Shailender Singh
Background/Aims: Esophageal stricture is usually managed with outpatient endoscopic dilation. However, patients with food impaction or failure to thrive undergo inpatient dilation. Esophageal perforation is the most feared complication, and its risk in inpatient setting is unknown. Methods: We used National Inpatient Sample (NIS) database for 2007-2013. International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes were used to identify patients with esophageal strictures...
March 17, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28282009/low-abdominal-wall-thickness-may-predict-percutaneous-endoscopic-gastrostomy-complications
#2
Melissa K James, Vanessa P Ho, Simon P Tiu, Richard J Tom, Taylor R Klein, Gloria M Melnic, Sebastian D Schubl
Although percutaneous endoscopic gastrostomy (PEG) tube placement is a common and safe procedure to provide enteral feeding, some patients develop complications. The aim of this study was to identify risk factors for the development of post-PEG complications. We hypothesized that patients with low albumin, diabetes, higher body mass index (BMI), thicker abdominal walls, or psychomotor agitation would have more complications. A 2-year retrospective review was performed on patients who received a PEG tube at a single institution...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28255151/abdominal-wall-necrotising-fasciitis-a-rare-but-devastating-complication-of-the-percutaneous-endoscopic-gastrostomy-procedure
#3
M R Mohd Said, R Abdul Rani, R A Raja Ali, C S Ngiu
Percutaneous Endoscopic Gastrostomy (PEG) tubes were often offered to patients requiring long term enteral feeding. Even though the procedure is relatively safe, it is associated with various complications such as peritonitis or even death.1 We presented a case of a 54-year-old gentleman with underlying ischemic stroke and pus discharges from a recently inserted PEG tube. Computed Topography (CT) scan confirmed abdominal wall necrotising fasciitis complicated with hyperosmolar hyperglycaemia state (HHS) and later succumbed after 48 hours of admission...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28243007/analysis-of-patients-%C3%A2-65-with-predominant-cervical-spine-fractures-issues-of-disposition-and-dysphagia
#4
Lisa M Poole, Phong Le, Rachel M Drake, Stephen D Helmer, James M Haan
BACKGROUND: Cervical spine fractures occur in 2.6% to 4.7% of trauma patients aged 65 years or older. Mortality rates in this population ranges from 19% to 24%. A few studies have specifically looked at dysphagia in elderly patients with cervical spine injury. AIMS: The aim of this study is to evaluate dysphagia, disposition, and mortality in elderly patients with cervical spine injury. SETTINGS AND DESIGN: Retrospective review at an the American College of Surgeons-verified level 1 trauma center...
January 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28228206/low-abdominal-wall-thickness-may-predict-percutaneous-endoscopic-gastrostomy-complications
#5
Melissa K James, Vanessa P Ho, Simon P Tiu, Richard J Tom, Taylor R Klein, Gloria M Melnic, Sebastian D Schubl
Although percutaneous endoscopic gastrostomy (PEG) tube placement is a common and safe procedure to provide enteral feeding, some patients develop complications. The aim of this study was to identify risk factors for the development of post-PEG complications. We hypothesized that patients with low albumin, diabetes, higher body mass index (BMI), thicker abdominal walls, or psychomotor agitation would have more complications. A 2-year retrospective review was performed on patients who received a PEG tube at a single institution...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28139230/comparison-of-operative-outcomes-between-surgical-gastrostomy-and-percutaneous-endoscopic-gastrostomy-in-infants
#6
Shin Miyata, Fanglong Dong, Olga Lebedevskiy, Hanna Park, Nam Nguyen
PURPOSE: Safety profile of different gastrostomy procedures in small children has not been well studied. This study was conducted to investigate whether complication and mortality rates differ between surgical gastrostomy (G-tube) and percutaneous endoscopic gastrostomy (PEG) in infants and neonates. METHODS: In this retrospective study utilizing the Kids' Inpatient Database, all infants who underwent either G-tube or PEG as a sole procedure were identified. Variables included age, gender, race, presence of neurological impairment, prematurity, complex chronic condition, and severity of illness/risk of mortality subclasses...
January 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28009454/direct-estimation-for-adaptive-treatment-length-policies-methods-and-application-to-evaluating-the-effect-of-delayed-peg-insertion
#7
Xin Lu, Brent A Johnson
Dysphagia is a primary cause of death among patients diagnosed with amyotrophic lateral sclerosis (ALS), and percutaneous endoscopic gastrostomy (PEG) is a procedure to insert a tube into the stomach to assist or replace oral feeding. It is believed that PEG is beneficial and, generally, earlier insertion is preferable to later. However, gathering clinical evidence to support these beliefs on the use and timing of PEG is challenging because controlled clinical trials are not feasible and clinical endpoints are confounded with PEG in observational data...
December 23, 2016: Biometrics
https://www.readbyqxmd.com/read/27891266/a-silent-and-chronic-complication-of-percutaneous-endoscopic-gastrostomy-tube-small-bowel-enterocutaneous-fistula
#8
Sai Wah Cheung
Percutaneous endoscopic gastrostomy (PEG) has gradually gained the popularity since its invention and become the most preferred method for gastrostomy insertion in recent years. PEG is associated with lower morbidity and mortality and has the advantages of being minimally invasive and more convenient over the conventional open gastrostomy. However, significant rates of major complication still occur. Enterocutaneous fistula is one of the key complications that can be easily neglected due to its asymptomatic nature...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27799884/thirty-day-mortality-after-percutaneous-gastrostomy-by-endoscopic-versus-radiologic-placement-a-systematic-review-and-meta-analysis
#9
Joo Hyun Lim, Seung Ho Choi, Changhyun Lee, Ji Yeon Seo, Hae Yeon Kang, Jong In Yang, Su Jin Chung, Joo Sung Kim
BACKGROUND/AIMS: A percutaneous gastrostomy can be placed either endoscopically (percutaneous endoscopic gastrostomy, PEG) or radiologically (radiologically-inserted gastrostomy, RIG). However, there is no consistent evidence of the safety and efficacy of PEG compared to RIG. Recently, 30-day mortality has become considered as the most important surrogate index for evaluating the safety and efficacy of percutaneous gastrostomy. The aim of this meta-analysis was to compare the 30-day mortality rates between PEG and RIG...
October 2016: Intestinal Research
https://www.readbyqxmd.com/read/27737522/percutaneous-endoscopic-gastrostomy-tube-insertion-in-neurodegenerative-disease-a-retrospective-study-and-literature-review
#10
Pamela Sarkar, Alice Cole, Neil J Scolding, Claire M Rice
Background/Aims: With the notable exceptions of dementia, stroke, and motor neuron disease, relatively little is known about the safety and utility of percutaneous endoscopic gastrostomy (PEG) tube insertion in patients with neurodegenerative disease. We aimed to determine the safety and utility of PEG feeding in the context of neurodegenerative disease and to complete a literature review in order to identify whether particular factors need to be considered to improve safety and outcome...
October 13, 2016: Clinical Endoscopy
https://www.readbyqxmd.com/read/27678507/infant-gastrostomy-outcomes-the-cost-of-complications
#11
COMPARATIVE STUDY
Rachel M Landisch, Ryan C Colwell, John C Densmore
PURPOSE: Comparative outcomes of enhanced percutaneous endoscopic gastrostomy (PEG) and laparoscopic gastrostomy (LG) have not been elucidated in infants. We describe the outcomes and procedural episodic expenditures of PEG versus LG in this high-risk population. METHODS: One hundred eighty-three gastrostomies in children under 1year were reviewed from our institution spanning 1/2011-6/2015. Pertinent demographics and 3-month complications (mortality, gastrocolic fistula, reoperation, cellulitis, granulation, pneumonia, and tube dislodgement <6weeks) were collected...
December 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27573920/growth-and-nutrition-in-children-with-ataxia-telangiectasia
#12
Emma Stewart, Andrew P Prayle, Alison Tooke, Sara Pasalodos, Mohnish Suri, Andy Bush, Jayesh M Bhatt
BACKGROUND: Ataxia telangiectasia (A-T) is a rare multisystem disease with high early mortality from lung disease and cancer. Nutritional failure adversely impacts outcomes in many respiratory diseases. Several factors influence nutrition in children with A-T. We hypothesised that children with A-T have progressive growth failure and that early gastrostomy tube feeding (percutaneous endoscopic gastrostomy, PEG) is a favourable management option with good nutritional outcomes. METHODS: Data were collected prospectively on weight, height and body mass index (BMI) at the national paediatric A-T clinic...
August 29, 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27505401/peg-insertion-in-patients-with-dementia-does-not-improve-nutritional-status-and-has-worse-outcomes-as-compared-with-peg-insertion-for-other-indications
#13
Ayman Abu R, Tawfik Khoury, Jonah Cohen, Shmuel Chen, Shaul Yaari, Saleh Daher, Ariel A Benson, Meir Mizrahi
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) tubes are commonly utilized as a method of enteral feeding in patients unable to obtain adequate oral nutrition. Although some studies have shown improved mortality in select populations, the safety and effectiveness of PEG insertion in patients with dementia compared with those with other neurological diseases or head and neck malignancy remains less well defined. OBJECTIVE: To evaluate the nutritional effectiveness, rate of rehospitalization, and risk of mortality among patients with dementia compared with patients with other neurological diseases or head and neck cancers who undergo PEG placement...
August 8, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27496114/predictors-of-in-hospital-mortality-in-patients-with-metastatic-cancer-receiving-specific-critical-care-therapies
#14
Kah Poh Loh, Ankit Kansagra, Meng-Shiou Shieh, Penelope Pekow, Peter Lindenauer, Mihaela Stefan, Tara Lagu
BACKGROUND: In-hospital mortality is high for critically ill patients with metastatic cancer. To help patients, families, and clinicians make an informed decision about invasive medical treatments, we examined predictors of in-hospital mortality among patients with metastatic cancer who received critical care therapies (CCTs). PATIENTS AND METHODS: We used the 2010 California Healthcare Cost and Utilization Project: State Inpatient Databases to identify admissions of patients with metastatic cancer (age ≥18 years) who received CCTs, including invasive mechanical ventilation (IMV), tracheostomy, percutaneous endoscopic gastrostomy (PEG) tube, acute use of dialysis, and total parenteral nutrition (TPN)...
August 2016: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/27486522/percutaneous-endoscopic-transgastric-jejunostomy-peg-j-a-retrospective-analysis-on-its-utility-in-maintaining-enteral-nutrition-after-unsuccessful-gastric-feeding
#15
Ezekiel Wong Toh Yoon, Kaori Yoneda, Shinya Nakamura, Kazuki Nishihara
BACKGROUND/AIMS: Although percutaneous endoscopic gastrostomy (PEG) is the method of choice for long-term enteral nutrition, feeding-related adverse events such as aspiration pneumonia and peristomal leakage can impede the use of PEG. Percutaneous endoscopic transgastric jejunostomy (PEG-J) using large-bore jejunal tubes may help by circumventing gastric passage during enteral nutrition and improving drainage of gastric secretions. METHODS: 20 patients (12 males and 8 females) who received PEG-J after unsuccessful PEG feeding during a 6-year period in our institution were analysed retrospectively to evaluate the efficacy of large-bore jejunal feeding tubes in maintaining enteral nutrition...
2016: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/27329861/computed-tomography-guided-percutaneous-gastrostomy-jejunostomy-for-feeding-and-decompression
#16
Heinz Albrecht, Alexander F Hagel, Philipp Schlechtweg, Thomas Foertsch, Markus F Neurath, Jonas Mudter
BACKGROUND: An effective method for long-term enteral feeding or stomach decompression is the use of a percutaneous gastrostomy (PEG) or sometimes jejunostomy (PEJ). Under certain circumstances (eg, inadequate transillumination), endoscopic placement of PEG/PEJ tubes is impossible. In these cases, computed tomography (CT)-guided PEG/PEJ may represent an alternative technique. In this study, we evaluate indications, results, and complications of CT-guided PEG/PEJ. MATERIALS AND METHODS: A total of 102 consecutive referred patients were enrolled in the study...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27310995/trends-regarding-percutaneous-endoscopic-gastrostomy-a-nationwide-population-based-study-from-1997-to-2010
#17
MULTICENTER STUDY
Wei-Kuo Chang, Kuen-Tze Lin, Chen-Liang Tsai, Chi-Hsiang Chung, Wu-Chien Chien, Chun-Shu Lin
Percutaneous endoscopic gastrostomy (PEG) is widely used in patients requiring long-term tube feeding. Traditional PEG studies usually focused on practical, technical, and ethical issues. There have been little epidemiological studies on PEG utilization and services in Asia. We evaluated the changes in PEG utilization, patient selection, patient characteristics, and medical service in Taiwan from 1997 to 2010.This retrospective study analyzed the data of patients admitted for PEG tube placement according to the International Classification of Diseases, Ninth Revision (procedure code 43...
June 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27207937/survival-after-percutaneous-endoscopic-gastrostomy-in-older-adults-with-neurologic-disorders
#18
Ozgur Kara, Muhammet Cemal Kizilarslanoglu, Busra Canbaz, Gunes Arik, Hacer Dogan Varan, Mehmet Emin Kuyumcu, Mustafa Kemal Kilic, Fatih Sumer, Yusuf Yesil, Burcu Balam Yavuz, Mustafa Cankurtaran, Omer Ozturk, Taylan Kav, Meltem Halil
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) tube placement is a common procedure performed to provide a route for enteral feeding. We aimed to examine the survival after PEG in older adults with neurologic disease and to demonstrate the factors associated with mortality. METHODS: We analyzed the data of 500 patients who underwent PEG placement between 2005 and 2015 at a university hospital. The data included age, sex, follow-up duration, comorbidities, medications, indications for PEG, complications, and laboratory results...
May 18, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27181526/systematic-review-of-qualitative-and-quantitative-studies-on-the-attitudes-and-barriers-to-percutaneous-endoscopic-gastrostomy-feeding
#19
REVIEW
Mohamad Hasif Jaafar, Sanjiv Mahadeva, Karen Morgan, Maw Pin Tan
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is now commonly used in long-term care and community settings. However, regional variations exist in the acceptability of PEG tube feeding with long-term nasogastric feeding still commonplace in many Asian nations. AIMS: To evaluate the evidence relating to attitudes towards PEG feeding and to determine potential barriers to the acceptance of PEG tube feeding. METHODS: We searched Ovid MEDLINE, EMBASE, the Cochrane Library, Web of Science and CINAHL databases...
December 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27141303/comparing-open-gastrostomy-tube-to-percutaneous-endoscopic-gastrostomy-tube-in-heart-transplant-patients
#20
Vishnu Ambur, Sharven Taghavi, Senthil Jayarajan, John Gaughan, Yoshiya Toyoda, Elizabeth Dauer, Lars Ola Sjoholm, Abhijit Pathak, Thomas Santora, Amy J Goldberg
INTRODUCTION: Impaired wound healing due to immunosuppression has led some surgeons to preferentially use open gastrostomy tube (OGT) over percutaneous gastrostomy tube (PEG) in heart transplant patients when long-term enteral access is deemed necessary. METHODS: The National Inpatient Sample (NIS) database (2005-2010) was queried for all heart transplant patients. Those receiving OGT were compared to those treated with PEG tube. RESULTS: There were 498 patients requiring long-term enteral access treated with a gastrostomy tube, with 424 (85...
May 2016: Annals of Medicine and Surgery
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